Summary The authors personally studied 138 patients with liver granulomas: seventy-five (54%) had sarcoidosis, twenty-six (19%) had primary biliary cirrhosis, twenty-three (17%) had miscellaneous recognizable disorders and fourteen (10%) were undiagnosed. The modes of presentation, the clinical, biochemical and radiological features are compared, and the course of each disease is followed. The undiagnosed group were frequently middle-aged men presenting with abdominal pain, fever and hepato-splenomegaly. The unsatisfactory term granulomatous hepatitis, if used, should be reserved for this undiagnosed residue until follow-up reveals a more definite aetiology.