Nafidrofuryl oxalate induced hepatitis is uncommon but is a serious and potentially fatal complication. There is some evidence of clinical efficacy of nafidrofuryl oxalate in peripheral vascular disease and in May 2011 it was recommended by NICE. Nafidrofuryl oxalate is therefore likely to be used more frequently and so the incidence of hepatitis associated with it could increase. It is important to include drug induced hepatitis in the differential diagnosis in patients presenting with abnormal liver function tests.