Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease characterized by heterogeneous clinical, biochemical, immunological, and histological features, which may make its diagnosis challenging in clinical practice. This study aimed to analyze the diagnostic difficulties encountered in patients with suspected AIH and to highlight the role of a comprehensive diagnostic approach. We conducted a retrospective descriptive study over a five-year period from January 2019 to July 2025 in the Department of Hepato-Gastroenterology and Proctology at Ibn Sina University Hospital in Rabat. Clinical records of patients evaluated for suspected AIH were reviewed, and demographic, clinical, biochemical, immunological, and histological data were analyzed. A total of 24 patients were included, with a mean age at diagnosis of 45.5 years and a marked female predominance (83.3%). Cholestatic jaundice was the most common presenting manifestation (45.8%), followed by portal hypertension syndrome (29.2%) and chronic cytolysis (16.7%). Elevated serum IgG levels were observed in 79.2% of patients. Antinuclear antibodies and anti–smooth muscle antibodies were positive in 75% and 70.8% of cases, respectively. According to the simplified International Autoimmune Hepatitis Group (IAIHG) criteria, definite AIH was diagnosed in 11 patients (45.8%) and probable AIH in 3 patients (12.5%). In the remaining cases, alternative diagnoses were established, including primary biliary cholangitis, chronic hepatitis C, metabolic dysfunction–associated steatohepatitis, hepatic sarcoidosis, drug-induced hepatitis, and cryptogenic cirrhosis. Histopathological examination played a crucial role in confirming the diagnosis and identifying overlap syndromes or alternative etiologies. Patients with confirmed or probable AIH were treated with corticosteroids in combination with azathioprine, with favorable clinical outcomes in most cases. These findings underline the diagnostic complexity of AIH and emphasize the importance of integrating clinical, biological, immunological, and histological data to establish an accurate diagnosis and guide appropriate management.