Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease specific to pregnancy. The incidence of ICP shows significant geographical variations, with incidence rates between 0.1% and 27.6%. It often occurs in the late second and third trimester of pregnancy, although some cases of ICP have been reported in the first trimester. Pathophysiologically, this is a reversible delay in the excretion of bile acids, which have been consequently accumulated in the pregnant woman's blood. The disease resolves spontaneously after delivery but leaves an increased risk of recurrence in the subsequent pregnancy. The aetiology of the ICP is multifactorial and involves a combination of genetic, hormonal and environmental factors. The development of ICP is associated with mutations in the genes encoding biliary transport proteins on the hepatocyte membrane, the cholestatic effect of estrogen and progesterone and their metabolites, low levels of vitamin D and selenium in the winter months and with previous liver disease. Cholestasis of pregnancy is characterised by pruritus on the palms and soles and increased serum total bile acid concentration. The condition is mostly harmless to the mother. Still, it carries an increased risk of developing fetal complications: preterm birth, meconium-stained amniotic fluid, neonatal respiratory distress syndrome, fetal growth restriction, stillbirth and postpartum haemorrhage. The risk of developing fetal complications increases in parallel with the increase in bile acid values to more than 40 μmol / l. ICP treatment aims to alleviate symptoms and reduce the risk of developing fetal complications. The therapy of choice is ursodeoxycholic acid. The delivery timing depends on the clinical presentation, the serum bile acid concentrations, the estimated risk and gestational age.