The authors retrospectively reviewed the efficacy of percutaneous catheter drainage in treatment of abdominal abscess associated with fistulas. One hundred sixty four consecutive patients with abdominal abscesses drained percutaneously since 1985 at department of Radiology, Wonkwang University Hospital were studied. Among these, 13 patients were found to have fistulous communications to the biliary duct, the intestinal tract, or the renal calyx. Eleven patients (85%) were successfully treated without surgical intervention while two patients (15%) needed surgical drainage and fistulectomy. The duration of drainage ranged from 7 days to 9 months. Initial drainage of abdominal abscess was performed in the hospital, but 5 of 13 patients were discharged with a tube in place and were followed up as outpatients. In conclusion, percutaneous catheter drainage is an effective and safe means of treating abdominal abscesses with fistulas.