Introduction Liver abscess is a common and serious disease, and its prognosis is often poor if it is not diagnosed and adequately drained in a timely manner, despite extensive antibiotic treatment. Image-guided puncture treatment of liver abscess can eliminate the need for traditional surgical drainage and enable the patient to achieve a therapeutic effect comparable to surgical drainage with minimal damage, and shorten the course of the disease and improve the patient’s general condition more quickly. It has special application value especially for elderly and critically ill patients. At the same time, the diagnostic ability of liver abscess is improved during the puncture process, so that the correct diagnosis rate of liver abscess reaches 100%, which is higher than about 90% of ultrasound morphological examination. The method is safe, easy and practical, and provides an alternative method for clinical treatment of such patients. Advantages Image guided percutaneous puncture and drainage with high success rate, avoiding important organs and large blood vessels and reducing complications. Bacterial culture and drug sensitivity test can be performed on the extracted pus, which can help diagnose the etiology and guide the clinical use of drugs. Clinical application of subtransverse septal abscess and liver abscess with poor effect after using drugs are all indications for this method.