Typhoid Hepatitis is a rare presentation of typhoid fever, clinically suspected in patients with persistent fever hepatomegaly and jaundice and especially in cases where the liver function tests show predominantly conjugated hyperbilirubinemia, modest elevation of liver enzymes and negative serology for viral hepatitis. From January, 1989 to December, 1994, 476 cases were included in this study, 204 with typhoid fever admitted in JPMC Karachi and 272 in Civil Hospital, Quetta. Eleven percent cases had typhoid hepatitis. Nineteen (4%) cases were initially diagnosed as viral hepatitis and 33 (7%) developed jaundice later on. As typhoid is prevalent in Pakistan and typhoid hepatitis is a challenging problem, accurate and simple methods are required for diagnosis in all febrile cases. It should particularly be considered as a differential diagnosis for cases with fever, jaundice and hepatomegaly.