In 55 patients with ultrasonically demonstrated suspected hepatic malignancy, a fine needle aspiration biopsy and a coarse needle biopsy of the same focal lesion were performed under ultrasonic guidance. In 41 of 48 cases with proven malignancy, both biopsies were positive. In the remaining seven cases, only the fine needle aspiration biopsy yielded malignant cells. Tumor typing was possible in 2 primary and 33 metastatic tumors by examination of either the cytologic or the histologic specimen; an additional 6 metastatic tumors could be typed only by evaluation of the histologic specimen. Grading of six adenocarcinomas was performed with higher accuracy in the histologic than in the cytologic specimen. Exact determination of the primary site was not possible in metastatic tumors by use of either type of needle biopsy specimen. Since the less traumatic fine needle aspiration biopsy requires fewer prebiopsy precautions and has other advantages, the coarse needle biopsy should be restricted to the few cases in which the former does not yield sufficient information.