A variety of hepatobiliary disorders may complicate inflammatory bowel disease (IBD). Intrahepatic cholestasis of pregnancy (ICP) is associated with an increased risk of the subsequent development of IBD in population cohort studies. Our maternity facility manages 10000 births per annum and we present a retrospective audit of 17 women with acute fatty liver of pregnancy (AFLP) from 2000-2017. Five cases were associated with pre-existing IBD, one woman developed AFLP following presumed influenza hepatitis, and another following ICP. Two previous reports have described AFLP in women with ICP but there is no published relationship between AFLP and IBD. Increased levels of inflammatory cytokines including TNF-alpha have been demonstrated in IBD and ICP. Elevated levels of TNF-alpha have been shown to impair mitochondrial fatty acid beta-oxidation in Reye's syndrome, another hepatic micro-vesicular steatosis disorder which shares clinical and histological features with AFLP. Potential mechanisms linking IBD, ICP and AFLP are discussed.