High bilirubin does not usually cause leg pain; muscle and joint pain can occur in the presence of hemolysis. Bilirubin is divided into direct and indirect bilirubin, which are metabolites of hemoglobin from red blood cells in the blood system. Indirect bilirubin is formed first, which combines with proteins and enters the liver, and then combines with glucuronic acid to form direct bilirubin, which is finally formed into bile and urinary bilirubin and excreted. Elevated bilirubin is generally associated with red blood cells and the hepatobiliary system. When the liver is unable to metabolize bilirubin due to abnormal liver function, it can lead to elevated bilirubin and symptoms such as jaundice and loss of appetite, and when too many red blood cells are destroyed leading to high bilirubin it can lead to symptoms such as dizziness, fatigue, and muscle and joint pains. When the patient has high bilirubin and leg pain, it is recommended to improve the auxiliary examination to clarify the cause of the disease and then carry out targeted treatment, so as not to delay the condition.