Two children presented with acute hepatitis after starting therapy with atomoxetine (StratteraR). In one child, no competing diagnosis could be identified, and liver injury resolved completely on with drawal of the medication. In the second child,the evaluation was suggestive of type 1 autoimmune hepatitis;she subsequently improved with removal of atomoxetine and concomitant immunosuppressive therapy. Atomoxetine may cause clinically significant hepatotoxicity either by metabolic idiosyncrasy or by inducing autoimmune hepatitis. Two children presented with acute hepatitis after starting therapy with atomoxetine (StratteraR). In one child, no competing diagnosis could be identified, and liver injury resolved on with drawal of the medication. In the second child, the evaluation was suggestive of type 1 autoimmune hepatitis; she subsequently improved with removal of atomoxetine and concomitant immunosuppressive therapy. Atomoxetine may cause clinically significant hepatotoxicity either by metabolic idiosyncrasy or by inducing autoimmune hepatitis.