A 70-year-old woman had a large accessory liver lobe causing abdominal pain and requiring laparotomy. Four previous cases have been reported in the literature in which laparotomies were performed for acute abdominal symptoms secondary to torsion. In this case, there was no twist of the pedicle, and the symptoms were chronic. Atrophy of the left lobe was also present, perhaps related to the presence of postnecrotic cirrhosis. Excision of the accessory liver lobe was followed by complete disappearance of the symptoms.