We described a case of atypical hepatocellular carcinoma (HCC) in an AIDS patient. The patient presented with fever and leukocytosis and had no evidence of chronic hepatitis clinically and radiologically. Ultrasonography showed multiple variable sized low echoic nodules, which had low echoic peripheral halo, in both lobes of the liver. Contrast enhanced CT scan showed multiple well demarcated and low attenuated nodules in both lobes of the liver. Hepatic and portal veins were intact. Percutaneous core biopsy for hepatic nodules revealed cod-like distribution of malignant cells and HCC with trabecular type was finally diagnosed.