A liver scan performed for suspected Budd-Chiari syndrome revealed diffusely decreased uptake of the radiocolloid in the liver, except for a region in the liver corresponding to the caudate lobe. Enhanced CT scan clarified the changes in the liver anatomy and the presence of a hypertrophied caudate lobe. On Doppler examination, there was no flow in the major hepatic veins, and the flow in the portal vein was away from the liver. This case demonstrates the complementary role of the three modalities in the noninvasive evaluation of suspected Budd-Chiari syndrome.