IN SPITE of recent advances in diagnosis and treatment, liver abscess remains a challenging problem with a high mortality. The 50% death rate in these patients is chiefly related to the confusing clinical picture, often leading to delay in recognition and curative treatment. Hepatic abscess must be given prime consideration in any patient with sepsis when pain in the right upper abdomen or shoulder and hepatomegaly are present. Clinical Material This study is based on 22 patients with liver abscess seen at the Los Angeles County General Hospital during the past ten years. The diagnosis of pyogenic abscess was confirmed by autopsy or surgical findings in all cases. Three patients probably had associated amebiasis, although Endamoeba histolytica was not recovered from the abscess or colon. Thirteen patients had a solitary abscess while nine were multiple. Surgical exploration and drainage were performed in 15 patients; in this group the mortality was