| Objective Compare the clinical effect, safety and practicality of percutaneous puncture drainage (PCD) under CT-located or CT-guided PCD in the treatment of abdominal diseases. Methods Clinical data of 57 patients with abdominal diseases, who underwent PCD treatment from Jan 2014 to Dec 2018, were retrospectively analyzed. The patients were randomly divided into two groups: PCD with the CT-located (CT-located group) and CT-guided (CT-guided group). The puncture catheterization time, relief time of abdominal symptom, drainage time, puncture cost, cure rate and complications rate etc. were compared between two groups. Results PCD was successfully completed in all patients. The cure rate was 89.29% in CT-located group and 93.10 % in CT-guided group; there was no statistically difference between the two groups (χ2= 0.259, P>0.05). The average puncture catheterization time, the average relief time of abdominal symptoms, the average drainage time and the average postoperative hospital stay were［(20.48±4.67) min vs. (18.52±3.71) min, (1.81±0.74) d vs. (1.74±0.71) d, (12.84±4.25) d vs. (11.78±3.97) d, and (12.96±3.55) d vs. (11.96±3.26) d］, respectively in the two groups; there were no statistically differences between the two groups (t=1.710, 0.376, 0.629, 1.078, P> 0.05). In the cost of puncture, the CT-located group was significantly less compared with the CT-guided group［(578.5±20.08) yuan vs. (1501.8±144.73) yuan］, and the difference was statistically significantly (t=-32.948, P<0.01). The incidence complications of CT-located group was 14.29%, including 1 case of pain at the puncture site, 1 case of hosting, 1 case of blockage, and 1 case of bleed; the incidence complications of CT-guided group was 10.34%, including 2 cases of pain at the puncture site, 1 case of blockage, there was no statistically difference between the two groups (χ2=0.205, P>0.05). After treatment, 4 cases were lost for follow-up. All other patients recovered smoothly without relapse during the 6 months of follow up. Conclusion CT-guided PCD and CT-located PCD can achieve the similar effect for the treatment abdominal diseases with the advantages of minimal trauma, safe and practicality. Although the cost of CT-located PCD is lower, it requires high technology and there are some limitations in the scope of clinical application.