Objectives: The objective of our follow-up study is to evaluate liver enzymes in acne patients treated with isotretinoin. Setting: Dermatology outpatient clinics, MIMS, Mandya. Participants: we included the patients diagnosed with moderate to severe acne. All patients were treated with low dose isotretinoin and followed-up in our outpatient clinics 20 weeks. Patients were subjected to an interview questionnaire which included data on age, gender, previous treatment and liver enzymes. Primary outcome: Blood analyses were repeated in the follow-up visits baseline, 4,8,12,16,20 weeks. Results: AST, ALT of 40 patients aged 15-40 years receiving isotretinoin for moderate to severe acen were monitored before, during and every month interval for 4 months. Pretreatment values of mean AST and ALT levels are 12.58±3.58 and 10.76± 2.70 repectively. Values of AST and ALT were increased from the baseline. There is statistically significant increase in the levels at second, third and fourth month. The values were increased two times the upper limit upto grade 2. Conclusion: The present study showed statistically significant increase in liver aminotranferase, the increase was >two times the upper limit of normal.