A 48-year-old female patient, morphologically confirmed with unilateral left breast carcinoma two years ago, has been on maintenance therapy with tamoxifen. Recently, the patient presented with complaints of fatigue, right upper quadrant pain and back pain. These symptoms raised concerns about hepatic damage. Subsequent investigations revealed elevated hepatic enzymes. Neither the patient nor her family members have a history of hepatic dysfunction. Consequently, tamoxifen induced injury was suspected due to the absence of other apparent causes. Careful follow-up and a timely change of therapy prevented the occurrence of further serious adverse events.