The article describes the involvement of a clinical pharmacist in the pharmacotherapeutic process of a patient with severe intrahepatic cholestasis of pregnancy concomitant severe hyperlipidemia. Upon admission, the patient presented with triglyceride levels as high as 37.47 mmol·L^-1, cholesterol levels of 15.70 mmol∙L^-1, and total bile acid levels elevated to 64.30 µmol∙L^-1, indicating a significantly increased risk of complications such as acute pancreatitis and intrauterine fetal demise. How to ensure the safety and efficacy of the medication at the same time is a major challenge in the treatment of this patient. The clinical pharmacist recommended a treatment regimen comprising ursodeoxycholic acid in combination with ademetionine 1,4-butanedisulfonate to lower bile acid levels, alongside fenofibrate combined with ezetimibe to manage hyperlipidemia. After adjustment, triglycerides, cholesterol, and bile acid levels decreasing to 11.10 mmol∙L^-1, 5.94 mmol∙L^-1, and 49.30 µmol∙L^-1, respectively. The patient's condition was stable, ultimately resulting in a favorable childbirth outcome. The clinical pharmacist provided personalized pharmaceutical care throughout the patient's treatment, and assisted the clinician to formulate a medication plan in a scientific and rational manner. This article can be served as a reference for the diagnosis and treatment of similar complex obstetric patients.

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