Pyogenic liver abscess is a life threatening disease. Management of pyogenic liver abscess has improved significantly with the advent of potent antimicrobial agents and advances in diagnostic imaging and imaging guided percutaneous procedures. Because of this progress, the classic traid of fever, upper right quadrant pain or fullness, and jaundice is rarely seen nowadays. Over the past three decades, percutaneous needle aspiration or catheter drainage guided by sonography or CT has become the therapy of choice for pyogenic liver abscess. Percutaneous pigtail catheterization reduces chances of exploration by surgery for liver abscess. Exploratory laparotomy is now indicated in cases of ruptured liver abscesses only. The advantage of sonographic over CT guidance is that sonography is a real-time imaging technique that allows monitoring of the course of the needles and catheters as they traverse tissues. CT usually is associated with longer procedure times because it is necessary to scan the region of interest every time confirmation of catheter is required. A review of 30 patients with pyogenic liver abscess treated at general hospital of Ahmedabad over a 3 year period was undertaken who were managed by percutaneous pigtail catheterisation along with other supportive procedures