This systematic review and meta-analysis evaluated therapeutic strategies for iliopsoas muscle abscess (IPA). Overall treatment success and mortality rates were 80.4% and 8.3%, respectively, with mortality escalating in complex cases. Modality-specific descriptive estimates showed mortality rates of 4.2% for percutaneous catheter drainage (PCD), 6.2% for open surgical drainage (OSD), and 12.7% for antibiotic monotherapy, with corresponding treatment success rates of 71.4%, 92.0%, and 64.6%, respectively. Length of hospital stay and recurrence were summarized descriptively because of inconsistent definitions and reporting across studies. Staphylococcus species were the most frequently identified pathogens among evaluable pus cultures (38.1%), with S. aureus predominating in primary IPA. In contrast, IPA of gastrointestinal or genitourinary origin was more frequently associated with Enterobacteriaceae. These findings support prompt risk stratification and individualized management based on abscess etiology, morphology, and local microbiology.
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