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Hepatic granulomas are identified in approximately 3% to 4% of liver biopsies in the Western world. Their presence raises a broad differential diagnosis for the pathologist to consider, including infectious, immune-mediated, and drug-induced etiologies. Certain histologic features of granulomas and the adjacent liver parenchyma can help narrow the differential diagnosis, although clinical and laboratory correlation is often necessary to establish a definitive diagnosis. The purpose of this article is to review the morphologic classification of hepatic granulomas and to discuss hepatic sarcoidosis, one of the most common immune-mediated causes.