A 63-year-old man was found on ultrasound examination to have a hepatic cystic mass with a mural nodule, which was mildly enhanced on contrast enhanced CT and MRI. At surgery, the cystic fluid was haemorrhagic and histological examination of the mural nodule demonstrated an organized haematoma. This case is of interest in that an apparent mural nodule was present in a non-neoplastic cyst. Haemorrhagic hepatic cyst with an organized haematoma should be included in the differential diagnosis of cystic neoplasms.