There are many causes of granulomas of the liver including infections, immunological aberrations, enzyme defects, drugs and other chemicals, and neoplasia (Table I). The commonest causes are tuberculosis, sarcoidosis, schistosomiasis and intrinsic liver disease. About 10 per cent of granulomas remain unidentified. In sarcoidosis, liver granulomas are usually inconspicuous and featureless. They are not associated with symptoms or abnormal physical signs. Sarcoidosis of the liver has three well-recognised clinical syndromes-chronic intrahepatic cholestasis, portal hypertension and the Budd-Chiari Syndrome.