Pyogenic liver abscess may have serious complications that need specific management. We reported a case of a young male patient aged 24 years old and complained of abdominal enlargement since 2 (two) weeks before. Abdominal ultrasound revealed multiple liver abscesses. Liver aspiration was performed and about 500 cc of yellowish purulent fluid was drained. During hospitalization the symptoms of fever and shortness of breath were getting worse although adequate antibiotic treatment had been given. Chest X-ray examination showed elevated right hemidiaphragm and right pleural effusion. Thoracocentesis and proof puncture showed purulent fluid. He was diagnosed with empyema as a complication of pyogenie liver abscess. Water Sealed Drainage (WSD) was performed to evacuate the fluid and he was given antibiotics. The patient's condition improved in several days.