A Case Report: A 26 year old, male admitted under Department of Gastroenterology, AIIMS Rishikesh with complaint of Jaundice since 25 days associated with fatigue & malaise. Patient also complained of gradual abdominal distention with pedal edema & decrease in urine output for 3 days & altered sensorium for 1 day. Patient was a chronic alcoholic consuming 100gms/day for 18years. Initially, on admission patient had stable vitals but increased prothrombin time, with raised serum bilirubin (44mg/dl). Serum electrolytes on admission were also altered. Patient was managed with TPE along with diuretics, antibiotics, steroids & protein supplements. 5 TPE procedures were done every alternate day with Fresh Frozen Plasma & 4% Albumin as replacement fluids. In this case, prothrombin time and serum bilirubin improved significantly after 5th procedure. Urine output and sensorium were also improved. Patient was discharged from the hospital with improved clinical symptoms and stable vitals.