A retrospective study of 18 adults admitted to Meir General Hospital with pyogenic liver abscess during the years 1982-88 was conducted. Our most useful diagnostic tool was ultrasound, which was accurate in all 15 patients in whom it was performed. Only two patients presented with multiple abscesses. Increased alkaline phosphatase was the most predictive laboratory finding, seen in all but one patient. One person was treated conservatively by antibiotics only. In one patient the abscess drained spontaneously into the right thoracic cavity. Initial surgical drainage was done in nine patients and percutaneous catheter drainage in seven. Only one patient died, of septic shock, yielding a mortality rate of 5.5%. The treatment-related complication rate, observed in almost half of the patients, was high. All patients with such complications required repeated drainage, which was achieved surgically in all cases.