<p>Amoxicillin-clavulanate is known to cause both liver injury as well as acute kidney injury. The majority of the existing literature has described liver-related injury, with fewer reports noting kidney injury. The simultaneous occurrence of both liver injury and renal failure together due to amoxicillin-clavulanic is a rare occurrence. In this report, we describe a case of concomitant drug–induced liver injury (DILI) and acute interstitial nephritis (AIN) following amoxicillin-clavulanate exposure. A 62-year-old African American male presented with 1&#xa0;week of generalized weakness, painless jaundice, nausea, vomiting, and diarrhea. Prior to admission, the patient had completed a 10-day course of amoxicillin-clavulanate for bacterial sinusitis. Upon admission, laboratory data revealed elevated liver transaminase levels and elevated creatinine levels suggestive of liver injury and renal failure respectively. Through tissue biopsy of both organs, the diagnosis of amoxicillin-clavulanate-induced acute liver injury and acute tubulointerstitial nephritis with bile cast nephropathy was made. This case highlights the critical role of tissue biopsy in reaching a unifying diagnosis for this rare adverse effect of amoxicillin-clavulanate. Through discovering biopsy results consistent with focal acute tubulointerstitial nephritis and hepatic cholestatic injury, the patient was diagnosed with amoxicillin-clavulanate-induced concomitant hepatic failure and renal failure, allowing for treatment with steroids that resolved the patient’s illness. Additionally, this case emphasizes the importance of antibiotic stewardship, given that the use of amoxicillin-clavulanic acid may result in multiorgan failure.</p>