Objectives: There is limited literature on pediatric liver abscesses (LA) in the Indian subcontinent. Thus, we aimed to study the epidemiological spectrum, clinical features, management approach, and outcomes of pediatric LA. Materials and methods: This was a retrospective, single-center analysis covering the period 2011–2021. It included all consecutive children under 18 years of age who were diagnosed with LA, and their profiles were examined. Results: A total of 92 children, with a median age of 10 (5–14) years, were included in the study. They were categorized as amebic liver abscess (ALA)—72.8%, indeterminate—15.2%, pyogenic liver abscess (PLA)—8.7%, and other causes—3.3%. The most common presenting complaint among all subjects was fever (100%), followed by abdominal pain in 76 cases (82.6%). The majority of cases had a single abscess (74, 80.4%), with a predilection for the right lobe (70%). Additionally, 75 children (81.5%) had a history of admission to an outside hospital prior to the presentation. Twenty children had complicated LA (21.7%), including 14% experiencing capsule rupture. The median duration of hospital stay was 9 (7–14) days. All children showed improvement with conservative management, which included broad-spectrum antibiotics, with or without percutaneous drainage. The median time to resolution was 34 (21–52) days, and none of the patients required surgical intervention. Conclusion: Diagnosing the exact cause of pediatric LA in the Indian subcontinent can be challenging; however, excellent outcomes can be achieved through a nonsurgical management approach. Clinical significance: In endemic regions, diagnosing pediatric LA is challenging due to limited diagnostics and overuse of antibiotics, yet simple parameters upon admission can predict complications, and nonsurgical management achieves excellent outcomes.