Twenty-one cases of hepatic hemangioma were examined by ultrasound, and three main sonographic patterns were identified. In 14 cases hyperechoic focal areas were observed, in five cases larger hemangiomas exhibited a complex pattern, and in two cases hemangiomas appeared as rounded sonolucent areas with distal enhancement mimicking cysts. Hemangiomas may have significantly variable ultrasonographic features. According to the authors' experience, only in cases of hyperechoic well-defined lesions in asymptomatic patients can a definite diagnosis of hemangioma be made.