Rhesus (Rh) hemolytic disease of the newborn represents a broad spectrum of symptoms in the fetus and newborn, ranging from mild to severe hemolytic anemia and hydrops fetalis. Cholestasis is a common problem in infants with immune hydrops fetalis (IHF). The aim of this study was to evaluate the incidence and course of cholestasis in infants with IHF due to Rh alloimmunization. Infants with IHF during the 10-year follow-up were retrospectively included in the study. Demographics, laboratory parameters, and prenatal and postnatal interventions were recorded. The incidence of cholestasis and certain risk factors were investigated. A total of 30 infants with IHF with a mean gestational age 33 +/- 2.6 weeks were included. Of these, 15 infants (50%) survived to discharge. The incidence of cholestasis was 60% (18/30). Cholestasis was diagnosed within a median 3 (0-7) days. All cholestatic infants who survived recovered within three months. In conclusion, cholestasis in IHF is frequent, transient and has an early onset.