Liver function tests are elevated in a variety of settings and with a mild elevation, it is difficult to decipher the cause. Typical causes of elevated liver enzymes may range from hepatocellular injury such as hepatitis C, to obstructive causes, such as primary sclerosing cholangitis. Primary sclerosing cholangitis is known to be associated with inflammatory bowel disease and may be more common than once thought.This article presents case study of a patient who presented with mildly elevated liver function tests and intermittent diarrhea. The patient was diagnosed with Crohn's disease and primary sclerosing cholangitis. The patient's presentation and the relation of inflammatory bowel disease and primary sclerosing cholangitis will be discussed. The importance of early detection of primary sclerosing cholangitis in an effort to decrease the morbidity and mortality from cholangiocarcinoma will also be emphasized. An overview of various diagnostic testing needed to make the diagnosis, as well as treatment modalities of both Crohn's disease and primary sclerosing cholangitis will also be presented.