This retrospective study was undertaken to evaluate the diagnostic usefulness of 97 sonographically guided fine needle aspiration biopsy cytologies in 92 patients with one or more hepatic lesions suspicious of malignancy. Results of the fine needle aspiration biopsy were then compared with the definitive results obtained by histologic examination, or with the subsequent course of the patient. A final diagnosis of malignancy was established in 65 cases, of which fine needle aspiration biopsy cytology revealed a concordant diagnosis in 54 cases. The diagnostic sensitivity of this technique was 83% for malignant lesions with 93% specificity. Of the 54 cases with malignant cytology, it was possible to distinguish between a primary or secondary lesion in 31 cases (57%). Benign lesions were aspirated in 32 cases, of which 30 cases concorded with the final diagnosis. This study confirms the usefulness of sonographically guided fine needle aspiration biopsy cytology in diagnosing malignant hepatic tumors.