Ciliated hepatic foregut cyst (CHFC) is a benign, solitary, and rare lesion [1, 2]. To date, nearly 109 cases have been reported [3, 4]. It was described in 1857 by Friederich but its current name dates from 1984 [5, 6]. It is suspected that a CHFC is a detached hepatic diverticulum or abnormal tracheo-bronchial bud that may have migrated caudally, to be included with the liver during the early embryonic development of the foregut hence the terminology of ciliated hepatic cyst of the foregut (CHFC) [2, 5, 6]. CHFCs are discovered incidentally very often during imaging, operative exploration or autopsy, because they are often clinically asymptomatic. But can manifest as abdominal pain in the right upper quadrant, sometimes as non-specific pain. Therefore, the prevalence and incidence remain difficult to determine [1, 2]. The age of discovery is most often around fifty, but can occur at any age. CHFCs are generally seen more in women [1, 2]. With the accessibility and advancement of imaging, diagnosis of CHFC is increasing. Classically, CHFCs are small (<4 cm) unilocular and avascular, and fluid-filled, and the appearance on imaging is variable often attributed to the elements of the cyst contents, including clear serous to white or brown material with different viscosities, located in the medial segment of the left hepatic lobe (segments 4 A and 4B [1, 2, 6]. Ultrasound evaluation usually reveals as a well-defined anechoic or hypoechoic small masses and hyperdense without enhancement on CT. Large variability is seen on MRI T1‐weighted imaging, including T1 hyper- or hypointensity. They may also show a fluid–filled layer due to the presence of fatty or protein-rich contents [1]. But CHFFCs are nearly exclusively hyperintense on T2 weighted imaging (usually not as hyper intense as a simple cyst) [1, 2, 3, 7]. The differential diagnosis for this lesion includes other unilocular hepatic lesions, such as simple hepatic cyst, echinococcal cyst, epidermoid cyst, pyogenic abscess, intrahepatic choledochal cyst, mesenchymal hamartoma, hypovascular solid tumor, and hepatobiliary cystadenoma or cystadenocarcinoma [1, 2, 7]. Definitive diagnosis is made through histology which reveals a pseudostratified columnar epithelium, subepithelial connective tissue layer, smooth muscle layer, and outer fibrous capsule [1, 5]. Rates of malignant transformation were reported to range from 3% to 5% with squamous cell carcinoma being the most common malignancy [3, 8]. The current management of CHFC remains controversial. Some believe they are incidental findings and generally asymptomatic, and therefore recommend observation [9]while others recommend a more aggressive approach, such as aspiration or surgical resection, due to a few reported cases of malignant transformation [ 10, 11, 12]. Overall, most authors agree that CHFCs should be surgically resected for cysts larger than 4–5 cm, lesions that are symptomatic or show interval growth, or asymptomatic lesions with worrying findings on imaging, such as focal wall abnormalities or thick septations [2, 13].