Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by an acute deterioration of liver function in patients with pre-existing chronic liver disease, leading to liver failure, organ dysfunction, and high short-term mortality. It is commonly associated with jaundice, coagulopathy, and the development of complications such as hepatic encephalopathy and ascites . Autoimmune hepatitis (AIH)–primary sclerosing cholangitis (PSC) overlap syndrome is a rare form of autoimmune liver disease in which features of both hepatocellular inflammation, typical of AIH, and cholestatic bile duct injury, characteristic of PSC, coexist. This overlap results in a complex clinical presentation and may predispose patients to rapid disease progression and liver failure . A 52 year old male was admitted to gastroenterology department with the complaints of fatigue, generalized pruritis . He has history of jaundice since last 3 months. The patient had past medical history of Type II Diabetes mellitus, CKD, DVT (around 8 months back). According to the physical examination, symptoms, diagnostic (Liver biopsy) and laboratory investigation (EBV PCR positive), the patient was diagnosed with Acute On Chronic Liver Failure – Overlap Syndrome (Autoimmune Hepatitis With Primary Sclerosing Cholangitis) and managed with IV antibiotic, oral steroid, and liver supportive medication.