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Granulomatous hepatitis has many causes. Drugs are an important etiologic factor. Several oral hypoglycemic agents are available for treatment of type II diabetes. Rosiglitazone, a thiazolidinedione, is a newer agent in this class. It has not been shown to be hepatotoxic in the premarketing trials. However, a few case reports have implicated it as a cause of acute hepatocellular injury. The authors report a case of granulomatous hepatitis associated with use of rosiglitazone. Liver function tests should be done regularly to monitor patients on this medication.