Medical records from 39 cats with hepatic disease, examined at the Veterinary Medical Teaching Hospital, University of Florida, between 1987 and 1992 were retrospectively evaluated for alterations in red blood cell (RBC) morphology. Diagnoses included: hepatic lipidosis, neoplasia, cholangiohepatitis, hepatitis/hepatopathy, systemic histoplasmosis, and portocaval shunt. A total of 56 laboratory data sets were studied which included complete blood counts and serum chemistry results. Stained blood smears were evaluated from 51 of the data sets. Twenty‐two cats (56%) were determined to have poikilocytosis on the basis of blood smear evaluation. Eleven (28%) cats had moderate to marked poikilocytosis (2 + to 4 +). Acanthocytes accounted for 62.6 ± 22.1% of morphologically abnormal RBC and were observed in blood smears from 100% of cats with poikilocytosis. Elliptocytes (ovalocytes) comprised 19.5 ± 15.8% of poikilocytes and were found in smears from 82% of cats with poikilocytosis. Keratocytes (7.0 ± 6.8%), schistocytes (3.6 ± 4.4%), and blister cells (2.6 ± 6.4%) were present in lower numbers and in fewer cats. Serum total cholesterol values were significantly greater (p>0.05) in cats with moderate to marked alterations in RBC morphology. Cats with hepatic lipidosis were significantly (p>0.04) more likely to have poikilocytosis than cats with other types of hepatic d