Objectives: The main objective of this study was to compare the disease characteristics, sign & symptoms, radiological and lab findings in two type's i-e Pyogenic and Amebic abscess. Further to identify important predictors of these two types. Study Design: Descriptive Study. Place and Duration of Study: Department of Medicine Civil Hospital Karachi from Jan 2007 to March 2010. Subjects and Methods: Medical records of all patients admitted in Civil Hospital Karachi (CHK) with a diagnosis of liver abscess were identified by using the International classification of diseases 9th revision with clinical modification (ICD-9-CM-USA) and reviewed retrospectively. Diagnosis of liver abscess was based upon clinical history and abdominal ultrasound or CT scan findings. Out of all cases of liver abscess only 210 confirmed cases were enrolled in this study. The data including demographic information, chief complaints duration of fever or abdominal pain, associated illnesses, malignancy and history of biliary surgery or other procedures along with laboratory investigations were collected through specially designed Performa. Results will be fed to SPSS 15.0 for statistical analysis where test of statistical significance were applied accordingly. Results: Out of total of 210 reported cases, 158 (75.2%) were amebic cases while the remaining 52 cases (24.8%) were pyogenic. Amebic cases reported significantly more with classical symptoms of fever with chills, abdominal pain and vomiting while higher percentage of cases reported symptoms of generalized weakness and cough in pyogenic liver abscess (p-value=0.0000). 21.2% of cases had history of diabetes mellitus. Rupture of abscess was observed in only 1 case. E.coli was the predominant pathogen (50% of cases) on culture report followed by Klebsialla pneumonia (35.4%) while remaining of the cases were polymicribial (14.6%). Conclusion: The occurrence of classical symptoms and signs of fever with chills, abdominal pain, vomiting, right hypochondriac pain and hepatomegaly are more likely to occur in amebic abscess while presence of multiple abscesses, gas formation and diabetes mellitus are strong predictors of Pyogenic abscess.