High bilirubin and normal aminotransferases are roughly caused by poor bile excretion, aggravation of hepatitis, and damage to the small bile ducts in the liver. 1. Poor bile excretion: patients with bile duct obstruction, bile bile excretion is not smooth, resulting in high bilirubin, choledocholithiasis, bile duct disease patients will be most of the cases. 2. Hepatitis aggravation: hepatitis patients have elevated aminotransferases in the early stage, but with the aggravation of the disease, the body’s blood cells occur bile enzyme separation, there will be a gradual increase in bilirubin, aminotransferases down to normal values. 3. Damage to small bile ducts in the liver: damage to small bile ducts in the liver caused by trauma, abnormal bile secretion causes abdominal discomfort, chills, fever and other conditions in patients, and if it is not controlled for a long period of time, there is a possibility of transforming into biliary hepatitis. This kind of indirect bilirubin is high but transaminase is normal, patients need to go to the hospital to find out the cause of the disease and carry out standardized treatment.