Abstract: Object To observe the clinical value of glucocorticoid in the treatment of patients with liver diseases and acute severe cholestasis. Methods Total of 68 patients with ineffective conventional treatment were given methylprednisolone 1 mg/(kg·d) for 3 days, then changed into 0.5 mg/(kg·d) for a week. For cases of hormone sensitive, oral prednisone 0.5 mg/(kg·d) were used. The total bilirubin changes of the hormone sensitive cases with 1 week or 2 weeks treatment were observed. Results Hormone sensitivity rate and hormone resistance rate were 86.8% and 13.2%, respectively. For 59 cases of hormone sensitive, TBil was (232.7 ± 98.2) μmol/L before treatment, (156.3 ± 71.6) μmol/L after 1 week treatment and (156.3 ± 71.6) μmol/L after 2 weeks treatment. Compared with the condition before treatment, there was a significant difference (t = 2.14, P = 0.021; t = 4.36, P = 0.004). Conclusions There is a certain value of patients with liver diseases and glucocorticoid in removing jaundice of early acute severe cholestatic.