We report a thirteen-month-old female with a history of abdominal distension for two months. She presented to the outpatient pediatric department with pallor, massive abdominal distension, and hepatomegaly. She was initially diagnosed with a liver abscess and admitted to the pediatric ward. Baseline labs, including liver aspirate culture and staining did not reveal any infectious etiology. The patient responded initially to empirical antibiotics, but abdominal distension continued to increase during admission. She was referred to gastroenterology where the investigations showed a solid-cystic liver mass. The patient underwent a surgery for mass excision, and a biopsy revealed mesenchymal hamartoma.