A liver abscess is a pus-filled cavity that occurs due to the incursion of microorganisms either from hematogenous spread or by way of the biliary ductal system. The common etiology of a liver abscess includes amoebic or pyogenic and sometimes mixed infections. In the developed world, a polymicrobial pyogenic abscess is common while amoebic etiology is more prevalent in tropical countries. Despite the improvement in sanitation and the advancement of treatment modalities, amoebic and pyogenic liver abscesses are considered an important cause of morbidity or mortality in the tropical and subtropical areas of the world. Aim & Objective:1. Compare the Percutaneous aspiration vs pigtail catheter drainage for liver abscess.2. study the clinical outcome in both procedure. Methods: Study design: Retrospective analytical study. Study setting: Department of surgery of tertiary care center. Study population: A total of 64 patients with a confirmed diagnosis of liver abscess. Sample size: 64. Results: A total of 64 patients with a liver abscess were analyzed. There was male predominance (93.75%). Mean abscess volume in Group C (307.9 ± 212.8 ml) was significantly higher when compared to Group A (130.8 ±72.9 ml, p = 0.03) and Group B (177.2 ± 129.5; p = 0.024). The duration of hospital stay and residual abscess volume at the time of discharge did not show a statistically significant difference between treatment groups. Pigtail catheterization of abscesses with volume >150 ml shortened the hospital stay, whereas it prolonged the hospital stay in patients with abscess volume <150 ml. Conclusions: Percutaneous pigtail catheterization would be an operative decision for the management of liver abscess. We concluded that the use of pigtail catheterization of patients with abscess volume > 150 ml improved the clinical outcome