We report two patients and review six additional published cases with liver penetrating peptic ulcer diagnosed by the finding of hepatic tissue in endoscopic biopsies. Clinical and laboratory data were non-specific. The presence of a large (2 cm) gastric or duodenal ulcer, with malignant appearance, or a protruding mass, with secondary ulceration and located in the gastroduodenal posterior wall or in the lesser curvature of the stomach, may suggest the endoscopic diagnosis of this complication. Definitive diagnosis is established by endoscopic biopsies of the ulcer base and/or of the associated mass.