A case report of a 23 year-old pregnant ivoman ivith the clinical, laboratory and pathologic features consistent with acute fatty metamorphosis of the liver in pregnant woman is presented. She delivered a viable premature female infant nnd healthy in both, and the literatures were reviewed. This is the 7th patient survived and only the 4th case with survival of mother and child without the use of tetracycline, added to our case in the literatures. This patient ivas treated for acute pyelonephritis and there ivas no evidence of acute pancreatitis or severe renal insu%ciency. In the present case, the onset of I]lness and jaundice appeared earlier than the reported cases and there ivas e,ere vaginal 'oleeding after the premature deliveri. The pathologic findings were morphologically characterized by a foamy cell type of fatty metamorphosis of all the hepatic lohules, accompanied by some mononuc]ear infiltrates around the periportal areas without necro.;is. Liver neddle biopsy is essentia! For the diagnosis of this disease, and the prognosis depends upon vigorous supportive treatments based on early suspicion and diagnosis.