Bilirubin metabolism is a complex and fascinating example of the body’s ability to discard, renew, and recycle νital elements. Jaundice is the warning sign for derangements in this system. As is true of pain, jaundice is a powerful impetus for visiting a healthcare provider. Usually associated with hepatitis by a nonclinician, the origins of jaundice can range from benign to fatally malignant. Patients may have any number of Idiopathic or nosocomial conditions that can contribute to an Icteric state. This review delineates the steps of bilirubin metabolism, enumerates the sources of bilirubin tierangement, and examines elements of patient condition and therapeutics that can contribute to hyperbilirubinemia and jaundice.