Due to the increasing utilization and sensitivity of radiologic imaging, the discovery of liver masses has risen dramatically, and approximately 250,000 patients are diagnosed with a liver lesion annually in the United States. Multiple imaging modalities are available that provide a wealth of information when interpreted correctly. As the morbidity and mortality associated with hepatic surgery continues to decrease, the clinical decisions surrounding these lesions have become more complex. The majority of liver masses are asymptomatic and found incidentally. When present, the most common symptom associated with liver masses is abdominal pain due to stretching of Glissen’s capsule. Patients may present with jaundice from an underlying liver pathology or biliary obstruction. Early satiety is caused by large masses creating gastric outlet obstruction. Finally, peritonitis can result from spontaneous rupture, and DIC can result from a consumptive coagulopathy secondary to hemorrhage.