Herbal medicines are widely used worldwide to treat minor ailments and prevent disease. Scotch pine ( Pinus sylvestris ) has many medicinal applications but is most well-known for its antiseptic properties and beneficial effects on the respiratory system. Herbal products can cause adverse side effects like liver injury, which is referred to as herb-induced liver damage (HILI). In this article, we present a patient who used Scotch pine to treat asthma and developed HILI. To the best of our knowledge, this is the first case of Scotch pine-related HILI described in the literature.