The authors report a case of multiple intrahepatic cholesterol stones found in an asymptomatic patient who had undergone cholecystectomy 12 years before. Biochemical abnormalities and radiologic and pathologic findings are noted. The patient underwent liver resection with Roux-en-Y choledochojejunostomy and received ursodeoxycholic acid postoperatively. Recovery was uncomplicated, and the patient was well at 1-year follow-up. Intrahepatic cholesterol lithiasis is rare but can be diagnosed preoperatively. Treatment depends on the presence of complications and the distribution of the stones.