This retrospective study was undertaken to evaluate the diagnostic usefulness of 244 sonographically guided fine- needle aspiration biopsy in 226 patients with ultrasonographically suspected hepatic malignant lesions. A final diagnosis of malignancy was established in 166 cases (73%) (145 hepatocellular carcinoma, 21 metastasis); benign lesions were aspirated in 60 cases (27%). The diagnostic sensitivity of this technique was 93%, with 100% specificity. When both cytology and microhistology were obtained, the positive correlation of the two techniques was 80% In the series of 244 fine-needle aspiration biopsy the authors had only one acute complication. They report one case of needle tract tumor seeding after biopsy. These results confirm the usefulness of sonographically guided fine-needle aspiration biopsy in diagnosing malignant hepatic tumors. The procedure is simple, safe, free of important side effects. The authors believe that ultrasound guided fine-needle aspiration biopsy represents the first choice of invasive technique in the assessment of hepatic focal benign lesions and malignant tumours.