Intrahepatic cholestasis of pregnancy has a prevalence of 1/1000 to 1/10000. Its etiology is multifactorial, involving genetic an hormonal factors, associated with adverse perinatal and obstetric outcomes. Report the case of patient 25 years old, with 32 weeks of gestation, which presents severe pruritus, jaundice, altered liver function tests and lipid profile, with presumptive diagnosis of intrahepatic cholestasis of pregnancy. Making weekly monitoring analytical biochemistry, test of fetal wellbeing, symptomatic management, with abdominal pregnancy termination at 35 weeks, for lack of clinical improvement, increase in metabolic disorders and intrauterine growth restriction, after induction of fetal lung maturity, with good obstetric and perinatal outcome. Definitive diagnosis by liver biopsy.