At liver magnetic resonance (MR) imaging in 38 patients, a breath-hold T2-weighted fast spin-echo (SE) pulse sequence optimized with fast recovery was compared with a conventional respiratory-triggered fast SE sequence and a breath-hold single-shot fast SE sequence. Mean signal-to-noise ratios for liver and contrast-to-noise ratios for hepatic lesions were higher with the breath-hold fast-recovery fast SE sequence than with the respiratory-triggered fast SE sequence (P <.05). Breath-hold fast-recovery images displayed better lesion clarity than did single-shot fast SE images (P <.05) and fewer image artifacts than did respiratory-triggered fast SE images (P <.05). The ability to determine lesion size and the overall image quality was best with the breath-hold fast-recovery sequence (P <.05). These results may justify use of the breath-hold fast-recovery fast SE pulse sequence for first-line T2-weighted MR imaging of the liver.