We report a 35 year-old woman with type 2 diabetes who developed acute fatty liver of pregnancy in her 35th week of pregnancy. She presented with nausea, vomiting, elevated transaminases, elevated bilirubin, renal impairment, and coagulopathy. Her condition improved dramatically after an emergency cesarean section. Acute Fatty Liver of Pregnancy (AFLP) is a rare life-threatening complication of pregnancy. The estimated incidence of AFLP was 5 cases per 100,000 pregnancies and case fatality rate was 1.8% in a prospective study [1]. Reported maternal mortality has ranged from none to 11% [2-4]. Non-alcoholic Fatty Liver (NAFL) is very common in type 2 diabetes [5]. However, the occurrence of AFLP in type 2 diabetes has not been previously reported. AFLP occurring in women with diabetes could be very dangerous. We report a rare case of AFLP in a woman with type 2 diabetes and raise an issue on the linkage between type 2 diabetes and AFLP with a brief literature review.