Image-guided aspiration and drainage of intra-abdominal fluid collections are performed for fluid characterization as well as the treatment of abscess and bulk symptoms. Review of imaging and patient history are critical to determining whether and how a collection should be drained, including choosing which imaging-guidance modality, approach, patient position, and drainage technique should be employed and whether an adjunct procedure such as hydrodissection may be necessary. Special scenarios such as pancreatic necrosis, subphrenic and deep pelvic collections, and tumor abscess will be discussed. This chapter will also review postprocedural care of drainage catheters, including the management of persistent collections refractory to percutaneous drainage and timing for catheter removal. The role of sclerotherapy will also be considered.