Gray-scale sonography has provided a means of following cases of successfully treated hepatic amebic abscess, allowing new insights into the natural history of this entity. In this study the majority of cases (23 of 32) resolved over a variable time period (1.5-23 months, median 7 months) to a normal sonographic hepatic parenchymal pattern. It is important that the transient, persistent abnormality seen after successful treatment not prompt reinstitution of therapy or further diagnostic testing in these patients. A smaller subgroup (six of 32) had sonographically persistent residua that appeared identical to benign simple cysts of the liver. The remaining three lesions showed slightly increased or decreased hepatic echogenicity after treatment.