OBJECTIVE: To describe a case of hepatic endometriosis. DESIGN: Case report. SETTING: University hospital. PATIENT: A 34-year-old woman with a 2-year history of cyclic right subcostal pain. INTERVENTIONS: Gonadotropin-releasing hormone agonist (GnRH-a) therapy followed by surgical resection. RESULTS: Ultrasonography, computed tomography scan, and magnetic resonance imaging of the liver disclosed a 6-cm diameter mass. The GnRH-a therapy for 4 months led to clinical and radiologic improvement. Surgery performed to allow pregnancy confirmed the diagnosis of hepatic endometriosis. CONCLUSIONS: Hepatic endometriosis is uncommon. It may result from metaplasia of the peritoneum or from hematogenic or lymphatic spread.