Eight patients with various forms of hepatic cystic disease studied with gray scale ultrasonography are described. Four had solitary cysts, two had multiple simple liver cysts, and two had congenital polycystic liver and kidney disease. The spectrum of ultrasonographic features in benign cystic disease of the liver is discussed. All eight patients were felt to have malignant disease in the liver prior to ultrasonographic evaluation. The value of gray scale ultrasound as a noninvasive means of differentiating cystic disease from suspected metastatic disease is emphasized.