Hepatic arteriovenous malformation (HAVM) is a rare vascular disorder characterized by abnormal anastomosis between hepatic arteries and veins. This chapter provides a comprehensive overview of HAVM, covering its etiology, clinical manifestations, hemodynamic implications, and imaging features. HAVMs can be idiopathic or secondary to various liver conditions, often asymptomatic but potentially leading to significant hemodynamic alterations. The chapter elucidates the underlying hemodynamic changes, emphasizing arteriovenous fistula formation and altered hepatic blood flow. Detailed exploration of imaging manifestations across various modalities—angiography, CT, MRI, and ultrasound—is presented, highlighting characteristic features such as early venous filling and transient perfusion abnormalities. Diagnostic challenges are addressed, offering key identification points and a comprehensive differential diagnosis. The importance of a multimodality imaging approach is underscored for accurate diagnosis and characterization. Management strategies are briefly discussed, noting that while small, asymptomatic lesions may be monitored, larger or symptomatic HAVMs often require intervention, with transarterial embolization as a primary treatment option. A case presentation illustrates practical application in a clinical setting. The chapter concludes with teaching points emphasizing HAVM rarity, potential hemodynamic impact, and the crucial role of imaging in diagnosis, providing a valuable resource for radiologists and clinicians.