Obeticholic acid is a farnesol receptor agonist that indirectly inhibits the expression of cytochrome genes, thereby inhibiting the synthesis of bile acids, promoting bile secretion, and reducing portal hypertension. Currently, it is mainly used in clinical practice for the treatment of primary biliary cirrhosis, but also for the treatment of non-alcoholic fatty liver disease and primary sclerosing cholangitis. It can be used either alone or in combination with ursodeoxycholic acid, but is contraindicated in patients with complete intestinal obstruction. Although obeticholic acid can cause side effects related to pruritus, fatigue, abdominal pain, rash, dizziness, constipation, and arthralgia, the overall tolerability is very good. While obeticholic acid has been marketed and sold in the United States as well as Europe, it is not yet available for sale in China, although some pharmaceutical companies have begun research work on generic versions.