Summary: Amoebic Liver Abscess in a 20-month-old child: A case of amoebic liver abscess in a Nigerian child is presented. Management consisted of 10days course of Metronidazole and 5days course of Tinidazole without improvement. This was followed by four sessions of ultrasound guided percutaneous needle aspirations over a period of 4 weeks with subsequent resolution and recovery. This high lights another method of dealing with difficult cases of amoebic liver abscess that may be employed when necessary.