Sonography is a major advance in the diagnosis of ALA. Identification of amoebic antigen in the pus is a specific immunodiagnostic test. Medical therapy with a single drug (metronidazole) is adequate in most instances. Routine needle aspiration or surgical drainage are not indicated. The abscess cavity may take up to 18 months for resolution and demonstration of such a lesion does not warrant repeated therapy unless clinical evidence of recurrence is present. Recurrences are rare. Clinical and laboratory evidences of poor prognosis are being identified, and may guide the treatment modality to be selected.