Dr. Navin Kumar, an attending Gastroenterologist at Brigham and Women's Hospital, medical educator at Harvard Medical School, and co-founder of the Run the List podcast and host Blake Smith discuss how to approach a patient presenting with acute right-upper quadrant (RUQ) pain. Together, they discuss the various causes of RUQ pain, in addition to how to approach a set of liver function tests (LFTs), differentiating hepatocellular injury from a cholestatic pattern. They then discuss how various forms of imaging (RUQUS, CT) can guide diagnosis and management, leading to a discussion about the use of ERCP and cholecystectomy in such cases. Lastly, the episode closes with a diagnosis and three clinical pearls about RUQ pain and abnormal LFTs.