Aim of the study: was to investigate the effectiveness of Percutaneous Needle Aspiration in comparison to continuous catheter drainage in the treatment of hepatic abscesses. Methods: A review of the scientific literature (From 1980 to October 2017) MEDLINE, EMBASE, SCOPUS, Current Contents, Cochrane Library, and Clinicaltrials.gov were searched to identify randomized controlled trials that investigated thoroughly the Percutaneous Needle Aspiration Versus Catheter Drainage in the treating of hepatic abscess and clearly met the inclusion criteria and the study primary endpoints (success rate, total resolution and mortality). Identification of papers and data extraction were performed by independent researchers. Results: the search yielded six eligible RCTs covering 348 patients. The meta-analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of success rate (RR: 0.79, 95% CI=0.64–0.97; P = 0.04), days to achieve a 50% reduction in abscess cavity size (SMD: −1.076, 95% CI 0.63–1.51; P < 0.00001) and overall clinical improvement (SMD: 0.71, 95% CI 0.35–1.09; P =0.0001). On the other hand, no significant difference was notable in the duration of hospitalization (SMD: −0.15, 95% CI −2.03 to 1.72, P = 0.84) or procedure-related complications (RR: 0.48, 95% CI 0.13–2.58; P = 0.39). Conclusion: The results of the present meta-analysis and systematic review indicated that PCD and PNA can be less safe and less invasive methods for the treatment of hepatic abscesses yet PCD is suggested to be more advantageous and superior to PNA.