Physiological jaundice in newborns is a frequent and generally harmless condition that resolves on its own. However, jaundice lasting beyond two weeks of age postnatal, particularly when associated with elevated conjugated bilirubin levels, warrants further investigation. This prolonged jaundice could indicate an underlying pathological issue, requiring differentiation between conditions such as biliary atresia (BA) and neonatal hepatitis. Landing introduced the term “infantile obstructive cholangiopathy” to describe a spectrum of disorders, including neonatal hepatitis, biliary atresia, and choledochal cysts. It is necessary to differentiate medical from the surgical causes of neonatal jaundice. The diagnosis may require a combination of clinical signs, biochemical tests, imaging and histological studies and sometimes a per-operative cholangiogram. Surgical management of BA is done with a modified Kasai portoenterostomy and the outcome depends on the age at surgery and quality of the liver. Other surgical causes needing intervention are choledochal cyst, inspissated bile syndrome and idiopathic perforation of bile duct.