Purpose : We report our experience of transrectal drainage of deep pelvic abscesses. Previously, pelvic abscess often preclude conventional anterior or anterolateral percutaneous approach due to danger of inadvertent puncture of intervening pelvic organs. Materials and methods : Transrectal drainage of pelvic abscesses was performed under the guidance of transrectal ultrasound and fluoroscopy. Included in the study were five patients ; two patients who had undergone subtotal gastrectomy and rectal resection, one received radiation therapy for uterine cervical cancer and two patients had pelvic abscess of unknown cause. Results : Drainage was successful in all patients and no serious complications occurred related to the procedure. Transrectal drainage procedure was well tolerated by all patients, except one who had received radiation therapy and complained pain during the catheter insertion. The catheter did not interfere with defecation and there was no incidence of catheter expulsion by defecation. Conclusion : Ultrasound guided transrectal drainage of deep pelvic abscesses is a feasible, safe and easy procedure in patients in whom conventional percutaneous approach is not appropriate.