Simple hepatic cysts are one of the most common benign lesions in the liver. Despite being frequently asymptomatic, if they reach large sizes in certain anatomical locations, they can appear under atypical symptomatology and cause significant morbidity. We present the case of a giant simple liver cyst as an exceptional cause of right-sided heart failure. Laparoscopic deroofing of the cyst achieved an outstanding improvement of the patient´s cardiac condition. A high diagnostic suspicion, a multidisciplinary approach and adequate treatment are essential for a favourable outcome.