Jaundice or elevated bilirubin is hallmark of most liver problems. It may occur because of increased production of bilirubin or decreased clearance (cholestasis). Cholestasis is due to mechanical obstruction in biliary tract (Obstructive Jaundice-OJ) or damage to the hepatic cells (Intrahepatic cholestasis). Intrahepatic cholestasis generally occurs at the level of the hepatocyte or biliary canalicular membrane and common causes are viral hepatitis, alcohol, fatty liver, drugs, autoimmune hepatitis, chronic liver disease or cirrhosis of varying etiology etcetera. When jaundice occurs due the mechanical blockage of any duct it is referred to as OJ. The focus of this article is on OJ. A patient with suspected biliary obstruction is approached in the following manner.