Liver cysts are more common benign liver diseases and are classified as parasitic and non-parasitic liver cysts. Non-parasitic liver cysts can be subdivided into congenital, traumatic, inflammatory and neoplastic cysts. Among them, congenital liver cysts are the most common, which can be divided into two types: solitary and multiple, and multiple liver cysts are also called multicystic liver. Solitary liver cysts are more common in the age group of 20-50 years, with a male to female incidence of 1:4. Multiple liver cysts are more common in women aged 40-60 years, with cysts of varying sizes, mostly involving the whole liver. Congenital liver cysts grow slowly and small cysts do not cause any symptoms and are mostly detected during ultrasound or CT examination. If the cyst increases to a certain extent, it may cause symptoms such as fullness after eating, nausea, vomiting, vague pain and discomfort in the right upper abdomen due to compression of adjacent organs. Picture 1 Simple hepatic cyst Picture 2 Multiple hepatic cyst After understanding what is hepatic cyst and its clinical manifestations, does hepatic cyst need to be treated? The treatment of liver cysts depends mainly on their size, nature and the presence of complications. For cysts with diameter ≤5cm, no obvious symptoms and slow growth, they can be reviewed regularly and generally do not need special treatment. When the diameter of the cyst is >5cm, or when abdominal pain, abdominal distension and other pressure symptoms appear, they should be treated. Commonly used treatment methods are: 1. Cyst puncture and aspiration under the guidance of B-ultrasound. 2.Cyst “windowing” or “debulking”: that is, partial removal of cyst wall under dissection or laparoscopy and aspiration of cyst fluid. 3.Cystectomy: If the cyst is located in the marginal part of the liver and protrudes to the abdominal cavity with the tip, then cystectomy can be performed. 4.Lobectomy or partial hepatectomy: for huge hepatic cysts in the left liver, lobectomy or partial hepatectomy can be performed. In conclusion, for small cysts with no obvious symptoms and slow growth, no special treatment is needed, only regular review to understand the change of cyst size and the presence of new cysts in the liver. In contrast, for those with larger cysts, faster growth and obvious compression symptoms, appropriate treatment can be chosen according to the patient’s physical condition and disease characteristics to remove the cysts and the compression symptoms caused by them. In addition, surgical treatment is generally not advocated for multiple liver cysts and is limited to the treatment of large cysts causing obvious symptoms to relieve their symptoms and eliminate the patient’s nervous and anxious mental state.