Background: Although eosinophilic liver abscess is not rare in clinical field, little has been known about its clinical characteristics and underlying mechanism. Objective: The goal of this study was to get more accurate and broad information on the clinical features and course of eosinophilic liver abscess. Method: We retrospectively reviewed medical records of the 54 patients with eosinophilic liver abscess from January, 2000 to December, 2003. Eosinophilic liver abscess was pathologically proven or clinically diagnosed by coexistence of peripheral eosinophilia and typical radiologic features on computed tomography. Mann-Whitney U test or KruskalWallis test were used for statistical analysis. Result: Many of them (n=33) were asymptomatic and incidentally found. Twenty patients (37%) had a history of malignancy. Gastric cancer (n=12) was the most common among them. Ten patients were diagnosed as parasite infestation. In 17 cases of eosinophilic abscess, there was no remarkable underlying disease that was known to cause eosinophilia. Peripheral eosinophilia did not always accompany the eosinophilic liver abscess. Conclusion: In most cases, patients with eosinophilic liver abscess had a benign course that was resolved without medication. Considering malignancy was the most frequent underlying disease among patients with eosinophilic liver abscess, clinicians should think over the possibility of hidden malignancy. (Korean J Asthma, Allergy Clin Immunol 2004;24:229-235) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ