Obeticholic acid is a pharmaceutical agent under development used especially to treat liver and gastrointestinal disorders. Its chemical structure is 6 α-ethyl-chenodeoxycholic acid (Figure1). It is a semi synthetic bile acid analogue. In human drug studies, Obeticholic acid is the first farnesoid X receptor agonist and at present, this drug is under phase-II and phase-III clinical trials. Various clinical studies were conducted by using this drug Obeticholic acid to assess the safety and efficacy. In this article, we reviewed the different studies available on Obeticholic acid and its therapeutic use in diseases like non alcoholic steatohepatitis, primary biliary cirrhosis, bile acid malabsorption and portal hypertension.