Background: Liver diseases have been known to be a major health problem principally because of their world-wide distribution. Focal liver disease is a common diagnostic problem referred to radiologists for evaluation owing to its nonspecific clinical presentation and marked interobserver variation on clinical examination. Aim of Study:The purpose of this study is to evaluate the role of diffusion tensor imaging in characterization of hepatic focal lesions and its value in post-treatment response.Patients and Methods: This prospective study included 30 patients previously diagnosed to have hepatic focal lesions (HFLs) by their characteristic triphasic computed tomography (CT), dynamic magnetic resonance imaging (MRI) features and/or biopsy. The study included 43 lesions in 30 patients (16 benign lesions, 23 malignant lesions, and 4 treated malignant lesions). MRI with diffusion tensor imaging (DTI) was performed for all patients. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were evaluated for all lesions.Results: There was a statistically significant difference in ADC values between the benign and malignant lesions (p<0.001) and between the treated malignant and untreated malignant lesions (p=0.002). There was a statistically significant difference in FA values between the benign and malignant lesions (p<0.001) and between the treated malignant and untreated malignant lesions ( p=0.004). The best cut-off ADC value to differentiate between benign and malignant lesions respectively was >1.42x 10 -3 mm 2 /s with 95.7% sensitivity and 82.8% specificity. The best cut-off ADC value to differentiate between treated malignant and malignant lesions respectively was >1.65x 10 -3 mm 2 /s with 97.8% sensitivity and 95.7% specificity. The best cut-off FA value to differentiate between malignant and benign lesions respectively was >0.29 with 95% sensitivity and 70% specificity. The best cut-off FA value to differentiate between treated malignant and untreated malignant lesions respectively was <0.297 with 100% sensitivity and 69.2% specificity. Conclusion: Diffusion tensor imaging is an evolvingtechnique that can be used to characterize different hepatic focal lesions either benign or malignant with significant