Severe ICI-induced liver injury progressing to acute or subacute liver failure carries a poor prognosis and presents a significant management challenge.<h4>Case presentation</h4>We present the case of a 58-year-old male with recurrent nasopharyngeal carcinoma who developed severe autoimmune hepatitis and subacute liver failure following his first cycle of tislelizumab (an anti-PD-1 antibody) combined with chemotherapy. The gene discussed is PDCD1; the disease is nasopharyngeal carcinoma.