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We present an atypical case of a patient with hepatic hemangiomas showing fluid-fluid levels on computed tomography (CT) and magnetic resonance imaging (MRI). None of the lesions showed contrast enhancement, mimicking complicated hepatic cysts or metastasis with hemorrhagic content. On contrast-enhanced ultrasound the lesions showed peripheral nodular enhancement with complete fill-in on late phases, suggestive of hepatic hemangioma. Teaching point: Contrast-enhanced ultrasound (CE-US) may be useful in diagnosing atypical hepatic hemangioma showing fluid-fluid levels on computed tomography (CT) or magnetic resonance imaging (MRI).