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Drug-induced hepatitis is one of the most common causes of the disease, but also one of the most difficult to diagnose. This is due to the plethora of drugs used in clinical practice, herbs and dietary supplements with hepatotoxic potential, the presentation by various clinical and pathological phenotypes, and the current lack of specific biomarkers. The diagnosis of drug-induced hepatitis is based on a combination of evidence and the elimination of differential diagnoses. For idiosyncratic hepatitis, the mechanisms of toxicity are often partially known, and no effective therapy has been found. In contrast, paracetamol toxicity is direct and dose-dependent, and N-acetyl cysteine has been shown to be effective in these cases. This review aims to provide an update on the diagnosis, treatment, and mechanisms of drug-induced hepatitis.