Liver is a vital organ with its multitude of functions, especially in children in whom it plays a crucial role in digestion. The portal circulation rich with nutrients absorbed from the small intestines is also a portal to infection from the outside world through contaminated food. The pediatric population suffers the most due to the complications of infection primarily, hepatic abscess. The outcomes depend on timely intervention and appropriate management. This article aims at highlighting some of the aspects of established and evidence based treatment strategies. The similar clinical presentation of the two types of liver abscess was a major hurdle in managing this curable yet perilous disease. The identification of the infectious etiology and abscess morphology is the key in determining the appropriate therapy. Invasive intervention while having multiple risks become inevitable if the disease is not treated on time. Hence a targeted approach tangible by early clinical diminution of the severity of the disease is the mainstay of treating any kind of hepatic abscess. We validate the best approach while highlighting the diagnostic sequence and treatment algorithm from different settings. The efficacy of antibiotic therapy combined with invasive drainage had proved the most successful in larger liver abscess while monotherapy with antibiotics remained adequate for others. The outcome with respect to time was variable.