Suppurative endophlebitis of the portal vein (pylephlebitis) is an unusual complication of appendicitis and other intraabdominal and pelvic infections that may progress from the mesenteric and portal veins to the liver parenchyma with abscess formation. Antibiotics have made pylephlebitis and liver abscesses infrequent; however, they do still occur. A case in which B-mode ultrasonography led to the diagnosis of portal vein thrombosis and liver abscess resulting from supperative appendicitis and pylephlebitis is reported.