The records of the Children's Memorial Hospital, Chicago, since 1954 included 22 cases of primary tumors of the liver: 11 were malignant hepatomas; 5, benign tumors; and 6, vascular malformations. In the malignant tumor group, five hepatic lobectomies and one wide excision of tumor were performed, as well as two pulmonary lobectomies for metastases. The malignant process was far advanced in five patients and surgical measures were limited to exploration and biopsy. All patients with malignancies died. The longest survival period was three years and four months postsurgery. In contrast to malignancies, all benign lesions were successfully resected, and the patients are alive and well. Tumors of vascular origin were limited to infants, and the lesions often caused significant hemodynamic manifestations. An aggressive approach with roentgenography and radionuclide scanning is advocated for early diagnosis of abdominal masses in pediatric patients. Surgical excision is indicated for all localized liver tumors.