We sought to define the risk of bleeding after percutaneous aspiration liver biopsy in patients with low platelet counts but otherwise normal clotting factors. Eighty-seven patients underwent liver biopsy using the Menghini 1-second technique with either a 1.6-mm or a 1.2-mm needle. Bleeding occurred in three out of 13 patients whose platelet counts at the time of biopsy were 60,000/mm3 or less, as compared to no bleeding in 74 patients with higher platelet counts (p = 0.003). A liver biopsy should not necessarily be withheld because of low platelet counts unless they are below 60,000/mm3 and cannot be raised for an adequate time during and after biopsy.