Culver EL, Bungay HK, Betts M, et al. - Researchers analyzed patients with ulcerative colitis (UC) and normal liver biochemistry, with or without colorectal dysplasia (CRD) in this prospective case‐control study to gain clarity regarding the prevalence, characteristics as well as long‐term outcome of sub‐clinical primary sclerosing cholangitis (PSC) diagnosed by magnetic resonance cholangiogram (MRC) in these patients. A total of 70 patients with UC and normal liver function (51 extensive UC, 19 CRD), 28 healthy volunteers (negative controls) as well as 28 patients having PSC and cholestasis (positive controls) were included. In patients with extensive UC and normal liver biochemistry, with or without CRD, the observed prevalence of sub‐clinical PSC seemed high. Advanced age, non‐smoking, pANCA, quiescent colitis, absence of azathioprine and high‐grade CRD were the factors that were related to sub‐clinical PSC. Long‐term follow‐up revealed disease progression and malignancy. Consideration should be given to MRC in all patients with extensive UC or CRD in order to stratify surveillance.