Solitary fibrous tumor of the liver is a rare tumor, where the evolution, malignant potential, and invasive growth have not been well defined. Although most cases are benign, there is no strict correlation between histological findings and biological behavior, and follow-up surveillance is necessary. We present the case of a large solitary hepatic fibrous tumor and its clinical outcome after a 4-year follow-up. Additional therapeutic options are also reviewed. The surgical resection is a plausible therapy in large solitary fibrous tumors of the liver, although liver transplantation may be discussed when the tumor is considered unresectable. However, such aggressive approaches are questionable in asymptomatic patients due to the natural history of this tumor, which is not well known, and the risk of complications.