Tuberculosis of the liver is uncommon except in association with miliary dissemination. Isolated macronodular hepatic tuberculosis is extremely rare. The clinical findings of the hepatic tuberculosis are nonspecific. Diagnosis is difficult in the absence of tuberculous involvemant elsewhere in the body. It is frequently misdiagnosed as primary or secondary tumor of the liver. Most of the cases reported in the literature are diagnosed at laparotomy or autopsy. The hepatic tuberculoma has a diagnostic challenge because it must be distinguished from the hepatic mass. In general, the primary approach of the treatment for hepatic tuberculoma is a medical management, but large tuberculoma of the liver is treated by surgical intervention. We experenced of 4 cases with hepatic tuberculoma diagnosed by ultrasound-guided fine needle aspiration biopsies in 3 cases and an open biopsy in 1 case. All of the patients were treated with an improvement or a complete recovery of clinical symptoms by antituberculous chemotherapy.