A 48-year-old obese man with a history of type II diabetes mellitus had hepatobiliary imaging because of right upper quadrant pain in the past year. The hepatobiliary scan showed an unusual configuration of possible hepatic activity extending into the right hemithorax. Subsequently, a liver-spleen scan confirmed abnormally located liver activity. Review of planar sestamibi cardiac studies performed 14 months earlier showed similar hepatic activity corresponding to the uptake seen on both hepatobillary and liver-spleen imaging. Abdominal computed tomography revealed an elevated right hemidiaphragm, with the liver located higher than usual, but with no morphologic abnormalities. The patient continued to have daily intermittent right upper quadrant pain exacerbated with movement and deep breathing, which was relieved by lying supine. This middle-aged obese patient had eventration of the right hemidiaphragm and required no treatment.