Gas-forming pyogenic liver abscess (GPLA), an uncommon and potentially fatal disease, represents 7%-24% of pyogenic liver abscess cases. Diabetes mellitus is a well-known risk factor for pyogenic liver abscess. Here, we present a case of GPLA in a 65-year-old man with diabetic mellitus and hypertension. The patient received computed tomography-guided percutaneous drainage, third generation cephalosporin and insulin control for hyperglycemia. He was discharged 20 days after admission without any complication.