The marked conjugated hyperbilirubinemia in a 72-year-old patient with myocardial infarction and sepsis is reported. The serum bilirubin, which was predominantly composed of conjugated bilirubin, was elevated to 21 mg/100 ml, while serum bile acid and alkaline phosphatase levels were normal or slightly elevated. Postmortem examination of the liver revealed slightly proliferated bile ductules and some bile thrombi with little liver cell necrosis.