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The liver is a rare site for anastomosing hemangiomas with only a few cases reported that characterize the lesions on magnetic resonance imaging (MRI). These lesions may be underreported due to overlapping features with classic hemangiomas. Anastomosing hemangiomas have a well-defined histological profile and are often diagnosed by biopsy in the setting of atypical imaging features.  We report a case of biopsy-proven hepatic anastomosing hemangioma found on a screening MRI for hepatocellular carcinoma in a 52-year-old female with cirrhosis. This lesion initially demonstrated interval growth but has shown no local recurrence in the 2-year surveillance period following microwave ablation.