Sint-Lievens-Houtem (French Hautem-Saint-Liévin, not officially recognized) is a Dutch-speaking municipality of Belgium. It is located in the Denderstreek and at the edge of the Flemish Ardennes, the hilly southern part of the province of East Flanders (Flemish Region). Sint-Lievens-Houtem is crossed by the Molenbeek in Vlierzele, Zonnegem and Letterhoutem.
The town comprises the former municipalities of Bavegem, Letterhoutem, Sint-Lievens-Houtem proper, Vlierzele, and Zonnegem, and the hamlets of Espenhoek, Cotthem, and Hoogveld, formerly parts of Oombergen.
In November every year, Sint-Lievens-Houtem holds a winter fair and livestock market, the Houtem Jaarmarkt, at which hundreds of traders sell cattle and horses. In 2010 it was inscribed on the UNESCO Representative List of the Intangible Cultural Heritage of Humanity.