〔Abstract〕 Objective To observe the clinical effect of ultrasound-guided drainage combined with Chaihu Qinggan decoction in the treatment of liver abscess. Methods A total of 64 patients with liver abscess admitted to Sanming First Hospital from February 2021 to March 2022 were selected and divided into a control group and an bservation group by blind selection lottery method, with 32 cases in each group. The patients in the control group were treated with ultrasound-guided drainage, and the patients in the observation group were treated with Chaihu Qinggan decoction on the basis of the control group. The therapeutic effect, clinical related indicators, liver function indicators before and after treatment, inflammatory factor levels, and the incidence of complications were observed and compared between the two groups.Results The total effective rate of the observation group was 96.88 %, higher than 78.13 % of the control group, and the difference was statistically significant (P < 0.05). The body temperature recovery time, extubation time, abscess disappearance time and hospitalization time of the observation group were shorter than those of the control group, and the differences were statistically significant (P < 0.05). After treatment, the leves of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) of the observation group were lower than those of the control group, and the differences were statistically significant (P < 0.05). After treatment, the leves of C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) and tumor necrosis factor–α (TNF–α) in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). The incidence of complications in the observation group was 6.25 %, lower than 18.75 % in the control group, and the difference was statistically significant (P < 0.05). Conclusion Ultrasound-guided drainage combined with Chaihu Qinggan decoction is more effective in the treatment of liver abscess, which can reduce the level of inflammatory factors, improve the liver function of patients, and has few complications and high safety.