The causes of high total bilirubin but normal aminotransferase mainly include physiological factors, which may also be caused by certain diseases, such as biliary tract obstruction, congenital non-hemolytic jaundice, severe hepatitis, intrahepatic bile blockage, hemolytic jaundice and so on. 1. Physiological factors: If the normal aminotransferase bilirubin is only slightly high, it may be caused by physiological factors, such as strenuous exercise, overwork and so on. 2. Pathologic factors: (1) Biliary tract obstruction: Biliary tract obstruction is one of the common causes of high total bilirubin but normal aminotransferases. Bile duct obstruction will lead to poor bile excretion, bile stagnation will cause high bilirubin, but at this time the liver function is not affected, and aminotransferase is normal. (2) Severe hepatitis: this symptom may also be caused by severe hepatitis. In patients with severe hepatitis, liver cells die in large quantities, the ability to process bilirubin decreases, and bilirubin will rise, while aminotransferases will gradually decrease due to progressive depletion. (3) Intrahepatic bile blockage: Intrahepatic bile blockage can also cause this symptom, which is related to the damage of small bile ducts in the liver and the abnormal bile secretion. (4) Hemolytic jaundice: In hemolytic jaundice, red blood cells are destroyed during hemolysis, and a large amount of unconjugated bilirubin is produced. If you find that the total bilirubin is high but the transaminase is normal, you should consult the doctor in time and give targeted treatment after the doctor clarifies the cause of the disease, so as to avoid delaying the condition.