Background: Biliary atresia is defined by progressive fibroinflammatory obliteration of the extrahepatic and intrahepatic bile ducts, almost always resulting in cholestasis, portal fibrosis, and biliary cirrhosis. Almost all patients with biliary atresia present with hepatomegaly, acholic stools, and chronic jaundice. Surgery is the main treatment for biliary atresia, but not all centers can perform surgery. In patients with cholestasis that is suggestive of biliary atresia, treatment with steroids may be a beneficial alternative to initial therapy in the setting of limited health capacity for the prevention of liver fibrosis. Case presentation: A 2-month-old, 4-day-old boy presented to the hospital with a chief complaint of jaundice. The patient had jaundice since the week after birth and underwent phototherapy for one week, but the condition persisted. Yellow-brown urine and pale or acholic stools were also reported along with the complaints. Laboratory findings included elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), reactive IgG and IgM cytomegalovirus (CMV), and elevated direct bilirubin (cholestasis). A two-phase abdominal ultrasound showed a pre-prandial GB volume of +/- 0.295 cc and a post-prandial volume of +/- 0.166 cc with a contractility index of 12.9%. The patient was given ursodeoxycholic acid at a dose of 2 mg/kg BW/day in addition to steroid treatment. Laboratory tests were monitored every two weeks. After 8 weeks of therapy, clinical manifestations, and laboratory results were within normal limits. Conclusion: In infants with cholestasis suspected of biliary atresia, steroid therapy may be a useful alternative initial therapy in limited healthcare facilities to help suppress the progress of inflammation leading to bile duct fibrosis.