Intrahepatic cholestasis of pregnancy is the most common liver disorder in pregnancy that adversely affects maternal well being and fetal outcome. We present a case of eclampsia that followed intrahepatic cholestasis of pregnancy in a patient who has a sister with the same history in her two former pregnancies despite being treated with ursodeoxycholic acid. Intrahepatic cholestasis and pregnancy is briefly reviewed based on a unique case report presenting with intrahepatic cholestasis complicated by eclampsia.