Objective: Confluent hepatic necrosis is the morphological correlate of fulminant liver failure. A group of these livers develop a combination of areas of necrosis and regenerative macronodules (RMN). Method: Sequential biochemical and clinical data and tissues from two groups of patients were compared. Group 1: 10 cases of submassive necrosis associated with RMN; Group 2: 19 cases with total confluent necrosis without nodular regeneration. Results: Group 1: mean age was 33,6 years (ranged 10 months-63 years); group 2 mean age was 42,6 years (ranged 18 months-63 years) (p>0,05). A longer course (42,8±34,6 days vs 12,6±6,0, p<0.05) and higher maximum serum bilirubin levels (23,5 mg/dl ±13,08 vs 14,9 mg/dl± 10,9, p<0 .05) were observed in group 1. Serum AST, ALT and gamma-GT were lower in group 1 (p>0.05). Morphologically livers from group 1 showed well defined regenerative green-yellow nodules with large regenerative hepatocytes in acinar pattern without surrounding fibrosis. The remaining parenchyma showed confluent necrosis, haemorrhage, mixed inflammatory infiltrate and ductular proliferation. Conclusion: A special anatomoclinical form of subacute liver failure was characterized by regenerative macronodules in a background of extensive confluent liver necrosis. Illness duration was longer and had higher maximum bilirubin levels than those without RMN.