Hemangiomas are the most common benign "solid” hepatic tumors, affecting up to 20% of the population, with a strong female predominance (thought to be related to estrogen influence on vascular endothelium). Although unlike adenomas, growth is not directly hormone-driven, and oral contraceptives (OCPs) or pregnancy are not contraindicated.   - Definition = thin epithelial capsule surrounding a vascular malformation of dilated channels supported by a fibrous stroma. No malignant potential; no risk of spontaneous rupture or bleeding.    - Imaging characteristics= Classically show peripheral, discontinuous nodular arterial enhancement with progressive centripetal fill-in on venous and delayed phases on CT or MRI. Markedly T2 hyperintense on MRI due to slow-flowing blood, with no uptake on hepatobiliary phase imaging (lack of functioning hepatocytes). No washout to below background liver on delayed imaging.   - Subtypes = Cavernous hemangioma (classic, most common), Capillary hemangioma (rare, smaller vessels), Giant hemangioma (>4–5 cm, may cause mass effect or pain).  Treatment & Surveillance =   - If asymptomatic, there is no need for treatment or follow-up.   - In patients with cirrhosis, they may shrink over time and do not mimic HCC growth patterns.  - Large/giant hemangiomas, observe unless symptomatic or diagnostic uncertainty.   - Symptomatic/complicated (pain, rupture [rare], Kasabach-Merritt syndrome [consumptive coagulopathy], rapid growth), offer surgery (resection or enucleation).  - Note, prior to resection consider preoperative interventional adjunctions for large lesions (embolization of portal vein or hepatic artery branches).