Surgical drainage has been the accepted method of treatment for pyogenic liver abscesses. Modern imaging techniques have revolutionized the diagnosis and management of liver abscesses. Percutaneous aspiration and drainage have been reported as a treatment modality of pyogenic liver abscesses in the literature before. We treated 15 patients with pyogenic liver abscesses by percutaneous aspiration and drainage. All patients responded except two. No mortality was observed. Review of the literature and our experience with 15 patients suggest that because of the high recovery rate and few complications percutaneous aspiration and drainage should be the first line of treatment in the management of pyogenic liver abscesses.