Abstract We report a case of a ciliated hepatic foregut cyst (CHFC) in the left lobe of the liver in a 42-year-old woman. To date, only 60 cases of these respiratory epithelial lined hepatic cysts have been reported since first described by Friedrich in 1857. CHFC are believed to be congenitally derived from the embryonic foregut and are considered benign lesions that are most often unilocular. Recently, however, there has been documented malignant transformation in these cysts. The majority of patients with a CHFC are asymptomatic and the cyst is usually an incidental finding during abdominal imaging studies or during surgical exploration. Interestingly, 85% of the total number of cases of CHFC have been reported within the last two decades. This recent rise in case reports is likely explained by greater detection because of the dramatic rise in the use of abdominal imaging. In our case, however, ultrasound failed to demonstrate any lesion within the liver and on computed tomography the cyst was more consistent with a soft tissue mass. Therefore, pathologic evaluation was necessary for the correct diagnosis of this liver lesion and to exclude malignancy.