We report a case of hepatic abscess in an immunocompetent patient due to Fusobacterium necrophorum possibly secondary to Lemierre syndrome. On admission, hepatomegaly was evident. Abdominal ultrasonography revealed a low-density lesion at the VII hepatic segment confirmed by computed tomography. A sample of drained fluid grew a strain of F. necrophorum, whereas blood culture were negative both for aerobic and anaerobic bacteria. Therapy with metronidazole improved both symptoms and radiographic images. Many cases of anaerobic hepatic abscess may be missed owing to difficulties in the isolation of anaerobes in many laboratories. Microbiology laboratory staff should be familiar with this microorganism. An early alert to physicians could avert delays in reaching diagnosis and specific therapy.