Objective To explore the clinical application of percutaneous puncture and drainage in treating pyogenic liver abscess. Methods A total of 30 patients with pyogenic liver abscess were treated with ultrasound-guided percutaneous puncture and aspiration of abscess cavity , which was followed by DSA-guided drainage tube placement together with proper washing of abscess cavity. Results Puncturing and flushing of abscess cavity was performed in two patients with < 4 cm liver abscess , and tube placement as well as drainage was carried out in the other 28 patients with > 4 cm liver abscess. No severe complications occurred. Complete cure was obtained in all the 26 patients who had no malignant tumors. Of the 4 patients with malignant tumor, cure obtained in one and death occurred in three. Conclusion Ultrasound-guided or DSA-guided percutaneous puncture and drainage therapy is technically simple, less invasive, highly safe and clinically effective treatment for pyogenic liver abscess.