Follow-up of 13 patients who underwent radiologically guided percutaneous needle aspiration of simple liver cysts revealed cyst recurrence in all patients within 2 years. While still effective as a primary diagnostic maneuver, percutaneous aspiration seems to lack permanent therapeutic benefit. However, it may be used as a therapeutic trial to confirm the origin of the patient's symptoms. The possible role of intracystic instillation of sclerosing agents was not studied in this series.