Amiodarone, a diiodinated benzofuran derivative, is widely used for treating ventricular and supraventricular tachyarrhythmias. Amiodarone is highly lipophilic and accumulation in the liver can be 500 times higher than serum amiodarone levels. Due to a long half-life and the lipophilic properties, the stored drug is capable of damaging the liver long after the drug has been stopped. Serious liver damage can lead to acute liver failure, cirrhosis and the need for liver transplantation. In this article we describe amiodarone-induced liver dysfunction and the diagnostic and therapeutic challenges in patients on amiodarone.