We present the case of a patient with chronic hepatitis B who developed an extensive intrahepatic hematoma, associated with a 30-fold elevation in serum alanine aminotransferase levels, following percutaneous liver biopsy. The patient was hypertensive but without hemorrhagic diathesis by routing tests done before biopsy. There was no concomitant intraperitoneal hemorrhage and no blood transfusions were required, despite a 9% drop in hematocrit. The complication was associated with short-lived, mild-to-moderate abdominal pain, easily relieved by paracetamol analgesics. The intrahepatic hematoma, as followed by computed tomography, resolved within 8 months. This case indicates that extensive intrahepatic hematoma and associated ischemic injury may infrequently complicate a liver biopsy and that hypertension may be a predisposing factor.