Although the term polycystic disease is usually associated with the kidneys, involvement of other organs such as the liver, pancreas, spleen and lung is not uncommon. However, in many such cases the polycystic disease is found only at autopsy or is incidental finding during laparotomy. Eight patients with polycystic liver and kidney disease were examined with gray-scale ultrasonography. The value of gray-scale ultrasound as a noninvasive means of differing cystic disease from suspected neoplastic disease is emphasized.