A 33-year-old male patient working as a butcher in a market was admitted to our clinic because of persisting fever and chills of 8-day duration, jaundice, disseminated myalgias and headache. Laboratory tests revealed a slight elavation of transaminases, marked hyperbilirubinemia of 17.5 mg/dl, and mild thrombocytopenia. His chest radiography was normal. Acute Q fever was diagnosed serologically by complement fixation, indirect immunofluorescence and trans-polymerase chain reaction from bone marrow. He was treated with ceftriaxone alone. Our patient was compared with other four similar acute cholestatic Q fever patients in the literature. One hundred and eleven cases of acute Q fever published to date from our country were reviewed.