The aim of this review of the recent literature on the current practice in the management of pyogenic liver abscess (PLA) is to highlight the important roles radiological procedures, particularly ultrasonography (US) now play in it. US equipment is now widely available in many African nations, yet not much is being done to embrace this current line of management. This is evidenced by the dearth of published work in this area from especially sub-Saharan Africa. It is being suggested that general surgeons and radiologists in this region collaborate more to reduce the cost of treating all cases by operations.