The diagnosis of granulomatous hepatitis was made on the basis of granulomas observed in the liver biopsies from 64 patients. It is shown that the macrophagal granulomas are, as a rule, localized inside the lobules, do not possess the characteristic features and represent the morphological manifestations of a non-specific reactive hepatitis. At the same time macrophagal granulomas may be a stage in the formation of the epithelioid-cell granulomas. The latter reflect the long persistence of the antigen in the liver macrophages. In certain cases the epithelioid-cell granulomas acquire specific features and these allow one, when analysing the liver biopsies, to confirm or to suggest the etiology of the disease (sarcoidosis, tuberculosis). An essential help in establishing the etiology of granulomatous hepatitis comes from the repeated clinical examination of patients and repeated liver punctures.