Gas gangrene (GG) is a severe infection typically caused by Clostridium species, often arising post-operatively. Here, we present a case of GG in the liver following microwave (MW) ablation for hepatocellular carcinoma (HCC), successfully managed with percutaneous Radiofrequency ablation (RFA). Despite initial antibiotic treatment for a suspected anaerobic liver abscess, the patient’s condition deteriorated, necessitating intensive care. Percutaneous drainage failed, and surgical resection was deemed unsuitable. RFA using cool-tip needles effectively treated the GG, demonstrating its potential as an alternative therapy when antibiotics and surgical options are inadequate or unavailable. Early intervention is crucial in such rapidly deteriorating cases.
