Twenty proven cases of amoebic liver abscess were treated at random with either tinidazole or metronidazole. The dose of both was 2 g once daily for 2 days. Clinical, radiological, and biochemical follow-up was done for 30 days. Of the 19 patients who completed the trial, complete recovery was observed in all 10 patients given tinidazole and in 5 of 9 patients given metronidazole (p=0.05). Moreover, patients on tinidazole required repeat aspirations less frequently than those on metronidazole. Mild gastrointestinal side-effects occurred in 1 patient on metronidazole. The results suggest that tinidazole is a more efficacious drug than metronidazole, with rapid therapeutic effect.