The infantile hemangio-endothelioma (IHE) of the liver, a rare neoplasm, may lead the clinician and the surgeon to suspect the presence of a malignant tumor, whereas histologic examination often reveals a benign condition; our case report illustrates this discrepancy in a 3 1/2-month-old girl suffering from multiple nodules in the liver. Conservative steroid treatment resulted in a marked reduction in tumor size; the girl is in good health more than two years after diagnosis. More than 80% of hepatic IHE are diagnosed during the first six months of life. Hepatomegaly, congestive heart failure and hemangiomas of the skin combine to the classic symptomatic triad. Since the mortality is high in untreated cases, early diagnosis is of importance. IHE may regress spontaneously. Therefore, conservative therapy, such as steroid medication and treatment of the secondary, tumor-induced complications appear indicated. Alternatively, embolization and/or resection of the tumor may be considered. Signs of cardiac or hepatic insufficiency at diagnosis and a low degree of histologic differentiation are of unfavorable prognostic significance.