Hepatic tumors most commonly present as a palpable abdominal mass. Primary hepatic neoplasms represent a small percentage of solid tumors in children. Infantile hepatic hemangioma (IHH), formerly infantile hemangioendothelioma, is the most common benign hepatic tumor of infancy. Biopsies are rarely indicated to differentiate IHH from other hepatic lesions, and due to the increased risk of bleeding, a biopsy of these masses is usually avoided. Ultrasound plays a critical role both in initial detection and localization and in follow-up of IHH. Differentiation of IHH from various other hepatic lesions is primarily based on clinical and radiologic features. Solitary IHH with degenerative changes and embryonal sarcoma of the liver (ESL) are distinguished by characteristic imaging features for hemangioma and the older age of presentation for ESL. The tumors are typically single well-circumscribed, unencapsulated, lobular masses that are paler than the surrounding normal liver. Focal nodular hyperplasia is a slow-growing tumor with no known malignant potential.