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Amoxicillin clavulanate (Augmentin) is one of the most commonly used antibiotics in New Zealand (NZ). There are a number of known adverse effects of this drug, affecting the cutaneous, gastrointestinal, hepatic, and haematologic systems. Hepatic adverse effects, although rare (17 cases per 100,000 patients treated with amoxicillin clavulanate), include drug induced liver injury (DILI). This case of DILI secondary to amoxicillin clavulanate after admission with choledocholithiasis highlights the importance of recognising and treating rare but severe medication adverse effects.