Liver abscess is the most common type of visceral abscess reported in the United States. Biliary tract disease is the most common cause of the development of liver abscess. In the last decade, many cases of liver abscesses silently manifesting as colon cancer have been reported in East Asian countries. We herein describe a case of an immunocompetent man who immigrated from East Africa to Unites States and presented with a suspicion of colon mass with metastasis to the liver, and who was later diagnosed to have a colonic malignancy with a concomitant liver abscess. Our aim was to make clinicians aware of the importance of ruling out occult colonic malignancy in patients with idiopathic liver abscess.