Hepatic cysts are a relatively common benign disease of the liver and a common condition in hepatobiliary surgery, some are so small that they can be less than 1 cm, and some are so large that the patient can resemble an October pregnancy. Since the widespread use of ultrasonography, asymptomatic congenital liver cysts are very common and often multiple, more frequent in middle-aged women and often associated with polycystic kidneys. Congenital liver cysts have a cyst wall composed of epithelial cells, the fluid is mostly colorless or transparent, or brown if there is bleeding, and multiple cysts are often small and spread throughout the liver. In small liver cysts, attention should be paid to exclude liver cancer, and in large liver cysts, attention should be paid to cyst rupture, some liver cysts are connected to the biliary system and are easily complicated by infection, which can easily lead to serious consequences if left untreated. For the treatment of liver cysts, the following methods are available according to the patient’s condition: 1) hepatectomy; 2) cystectomy; 3) cyst openings or large cyst excision; 4) cyst internal drainage; 5) cyst puncture and fluid aspiration and sclerosis. If complications such as cyst rupture, cystic torsion or intracapsular hemorrhage occur, emergency surgery will be performed. Polycystic liver should usually be treated non-surgically, as its lesions involve the whole liver, the disease cannot be cured unless liver transplantation is used. However, surgery should be considered to reduce the pressure once the hepatomegaly compresses the chest and abdomen and affects the respiratory circulation. Surgery for polycystic liver: Unless the lesion is limited to one lobe of the liver and is accompanied by symptoms; or if malignancy is suspected, surgery is generally not advocated. In polycystic liver, when individual cysts are found to be rapidly enlarging and compressing the neighboring organs, seriously affecting the patient’s daily life or cardiopulmonary function, repeated puncture and aspiration can be performed on the larger cysts. If the patient is in good general condition and has normal liver function, open-heart surgery can also be performed to reduce pressure, relieve symptoms and promote regeneration of liver cells. If possible, liver transplantation can be performed to completely cure the disease. Treatment of polycystic liver combined with polycystic kidney: It includes puncture or incision of the cyst to reduce the pressure of the cyst, which can sometimes delay the progression of the lesion and renal failure, and dialysis therapy if necessary. A radical cure requires a kidney transplant.