The progression of alimentary fatty liver to liver cirrhosis is a very rare observation. During the year after surgical extirpation of a suprasellar craniopharyngioma in a seven years old boy developed severe obesity and again six years later at autopsy a complete liver cirrhosis with fatty liver was established. Injury of the ventromedial hypothalamic nuclei and resulting hyperphagia is the reason for the obesity following suprasellar tumours. The pathogenesis of liver cirrhosis following alimentary fatty liver is not completely evident up to now, such a progression is possible - as shown in this case - also in children and within a short period.