A previously healthy 24-year-old pregnant woman in the 33rd week of gestation was referred to our institute from local obstetric hospital because of abnormal liver function. Initial laboratory findings showed hyperbilirubinemia, hypoglycemia, elevated liver enzyme, and prolongation of prothrombin time. Because a tentative acute fatty liver of pregnancy (AFLP) could be diagnosed according to symptoms, sign, and laboratory tests, immediate vaginal delivery was done. However, she suffered from progressive hepatic failure and encephalopathy after delivery despite aggressive support care. Thus, the decision to proceed with liver transplantation was made. Molecular absorbent recirculating system (MARS) was applied twice as a bridging therapy and then liver transplantation using cadaver liver was performed. After transplantation, the patient``s hepatic function and encephalopathy was fully recovered. We conclude that liver transplantation should be one of treatment options for AFLP if patient shows progresive hepatic failure and encephalopathy despite aggressive supportive care.