Serum Carbohydrate antigen 19-9 (CA 19-9), a marker of malignant tumors, is generally slightly elevated in benign conditions. We report a 58 year old male with jaundice and elevated CA 19-9 levels (8,474 IU/ml). Radiological imaging of the liver, pancreas and extrahepatic biliary tree revealed neither malignancy, nor obstruction. The only remarkable finding was biopsy-proven nonalcoholic steatohepatitis (NASH). This presentation indicates that significantly high CA 19-9 levels could be associated with NASH