Thyrotoxicosis is defined as the clinical syndrome resulting from the excess of thyroid hormones in the organism. It has several causes and a wide range of clinical manifestations, from mild tachycardia up to multiple organ failure. Although it is not unusual that patients with thyroid dysfunction have abnormal liver-function test these are usually mild and the initial presentation as severe liver failure is exceptional. We present a case report of a patient who developed a severe acute liver failure due to a non-controlled hyperthyroidsm. Also we conducted a review of all similar cases reported to date in the literature.