Background: Biliary cystadenomas are rare  benign neoplasm of the liver with a few hundred cases being reported all over the world. We herein report a series of 12 cases stressing on the importance of imaging and surgery in the management of this rare entity which is often misdiagnosed .

Materials and Methods: Records of 12 patients who underwent surgery for biliary cystadenomas between January 2010 to October 2017, were reviewed retrospectively.

Results: All the 12 patients in the were females with a median age of presentation of 36 (20-55) years. The most frequent symptom was abdominal pain (100%). 4 patients were misdiagnosed as hydatid cyst and one as simple cyst of liver. These were operated elsewhere and presented with recurrence after a median period of 6 months. Liver resection was performed in 8 patients and enucleation in other 4. No recurrence was reported during the follow-up period ranging from 3 months to 7 years. 

Conclusion: Biliary cystadenoma closely mimics other cystic space occupying lesions (SOL) of liver and needs to be differentiated from the same, as the treatment varies. Hepatic resection or enucleation of the cyst is the recommended treatment .