FNA of the liver is a diagnostic test that can be used to identify the vast majority of neoplasms of a primary or metastatic nature. Well-prepared FNA samples, in conjunction with cell button preparations, and correlation with the clinical history are necessary for optimal results. Even with the best of samples, however, well-differentiated hepatocellular neoplasms, both benign and malignant, and rare lesions still can remain difficult to diagnose by FNA.