A 25-year-old woman, with no past history of interest, was studied for a history of abdominal pain predominantly in the right hypochondrium. Physical examination and laboratory tests, including a liver profile, were normal. An abdominal ultrasound was performed, which revealed an 8-centimetre, multiloculated, hypoechoic cystic hepatic lesion with hyperechoic areas and calcium, located in hepatic segments 4-5 and with papillary projections towards the hepatic hilum. Given the impossibility of ruling out malignancy, surgical treatment was recommended. The patient underwent surgery and a cystic lesion of about 10 centimetres in diameter was found on the hepatic hilum, in segments 4 and 5, on the portal bifurcation and the middle hepatic vein. A cystopericystectomy with vascular control was performed without exclusion. The postoperative course was favourable and the patient was discharged after one week. The definitive histological diagnosis showed a ciliated liver cyst.