Aims: Primary hepatic tuberculosis is a rare benign disease, without typical manifestation and specific test, which usually contribute to the misdiagnosis of the disease. Therefore, we reviewed eleven cases of primary hepatic tuberculosis in our medical center, in order to find the common features, which might be conductive to improve the diagnostic accuracy of the disease. Methods: Eleven cases of hepatic tuberculosis confirmed by histopathological examination from 2012 to 2017, were collected in our hospital. Clinical features and outcomes were retrospectively analyzed. Results: All the patients were in good condition at admission, including seven male and four female, aging from 18 to 66 years (average 42.7 years). They disclaimed history of pulmonary and any extra-pulmonary tuberculosis. Tumor markers including AFP, CA19-9 and CEA were within the normal range. All the patients, with liver function classified as Child Pugh A, showed no signs of infection. The lesions were presented as hypo-echoic, cystic or solid-cystic in ultrasonography, low density with periphery enhancement on CT scan, and mixed signals on MRI. Two patients were initially diagnosed as liver cancer, two as liver benign tumor, three as hilar tumor, two as liver abscess, and one as others. Five cases underwent partial hepatectomy, two received laparotomy and drainage of the abscess, two experienced laparotomy and liver biopsy, and two with percutaneous needle biopsy. All recovered well after the operation, subsequently received regular treatment of anti-tuberculosis, and completely cured for hepatic tuberculosis. Conclusions: Surgical intervention is an effective way to clarify the diagnosis of asymptomatic primary hepatic tuberculosis.