A pelvic abscess is a life-threatening collection of infected fluid in the pouch of Douglas, fallopian tube, ovary, or parametric tissue. Usually, a pelvic abscess occurs as a complication after operative procedures. It starts as pelvic cellulitis or hematoma spreads to parametrial tissue. It can also present as a result of the complexity of certain medical conditions like sexually transmitted infection, pelvic inflammatory disease, appendicitis, diverticulitis, inflammatory bowel disease. Also, patients with pelvic abscess present with high-grade fever, leukocytosis, palpable pelvic mass, vaginal bleeding or discharge, and lower abdominal pain often associated with elevated sedimentation rate or C-reactive protein. Pelvic abscess responds well to adequate antibiotic treatment and hydration. Its variable presentation requires early recognition, diagnosis, immediate hospitalization, and treatment regardless of the size of the abscess. The current activity aims to explain the pathophysiology of pelvic abscess, elaborates on the importance of imaging techniques in diagnosing a pelvic abscess, and illustrates the necessary information that leads to identifying high-risk patients requiring immediate surgical intervention.