Peliosis hepatis is an uncommon condition of blood-filled cystic cavities in the liver. Although it is difficult to distinguish this condition from hepatic malignancy or abscess in computed tomography (CT), differential diagnosis is important because it doesn’t need further evaluation or treatment such as liver biopsy or surgery. We report a case of peliosis hepatis in a patient with active pulmonary tuberculosis in hemodialysis patient. A 39-year-old man receiving hemodialysis for 3 months was admitted because of fever. Chest computed tomography (CT) showed multiple necrotic lymphadenopathies and nodular lesion in right upper lobe of the lung suggesting active pulmonary tuberculosis. Three low attenuated lesions were shown in both hepatic lobes in abdominal CT. Liver biopsy was performed. The histopathologic diagnosis of peliosis hepatis in the liver was made by a blood-filled space with fibrin and hemorrhage. After anti-tuberculosis therapy, hepatic low attenuated lesions disappeared.