Three cases of an acute febrile disease were noted to have hepatic involvement as one of the major features of their illness. The clincial story was inconclusive, but liver biopsy showed the presence of a focal hepatitis characterized by the presence of giant cells, chronic inflammatory cells and epitheloid formation. The histological characteristics of the liver biopsy were initially considered to be consistent with tuberculosis and the diagnosis was made only after serological studies revealed a complement fixation consistent with Q fever. Though focal hepatitis has been reported in Q fever in the past, the granulomatous structure of the hepatic involvement has not been stressed. Chemical studies revealed the presence of an elevated alkaline phosphatase and a reversed AG ratio in all 3 cases. Two of the 3 cases had an elevated thymol turbidity test and mild elevation of the icterus index. All 3 cases had a prompt defervescence and progressive clinical improvement on 3 g of chloramphenicol per day and have remained well subsequent to their discharge from the hospital.