Female, 52 years old, Tibetan, with hepatocellular carcinoma, cirrhosis, and hypersplenism, 1 month after treatment by splenic artery embolization in a local hospital, presented with left upper abdominal distension and pain, gradually worsening, without fever, and CT examination showed: huge hypodense occupancy in the splenic area. The medical team in Tibet considered two possible diagnoses: 1) hematoma; 2) abscess. Angiography showed a huge filling defect in the splenic area and no signs of bleeding. After full discussion and communication with the hepatic surgery department and the patient’s family, percutaneous perforation and drainage treatment was performed under CT guidance, and a total of 1500ml of necrotic pus was drained, and the patient’s related symptoms were rapidly relieved. Summary: In recent years, splenic abscesses from various causes have become more and more common, and although many surgeons believe that splenic abscesses can only be treated surgically, we believe that percutaneous puncture and drainage for splenic abscesses, although risky, is easy to operate, and is minimally invasive, safe, and effective, and can be the treatment of choice with the assurance of a surgeon.