Iliopsoas Abscess—Advances in Diagnosis and Treatment

(1) Background: The iliopsoas abscess is a rare condition with potentially severe evolution, secondary to hematogenous or lymphatic dissemination (primary) or secondary to trauma, vertebral, renal, or gastrointestinal infections. Due to its deep anatomical location and varied etiology, it represents a diagnostic and therapeutic challenge, requiring a multidisciplinary approach (surgery, neurosurgery, orthopedics, urology, imaging, infectious diseases, rheumatology, physical medicine, psychology and psychiatry). The aim is to synthesize the clinical and paraclinical particularities and to update modern diagnostic and treatment methods. (2) Methods: A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases, including relevant articles addressing the aspects mentioned above. Available evidence remains heterogeneous and is derived predominantly from retrospective and observational studies, limiting direct comparisons between treatment modalities. (3) Results: Elements of etiological, clinical, and paraclinical diagnosis are presented, together with complex therapeutic options, both medical and surgical. All modern drainage methods are highlighted, including interventional imaging, minimally invasive techniques, endoscopic treatment (laparoscopic and retroperitoneoscopic), direct drainage through the inferior lumbar triangle (Jean-Louis Petit), as well as open surgical treatment. Immediate and long-term postoperative management, physical and functional rehabilitation, and psychological and psychiatric support complete the multidisciplinary approach. (4) Conclusions: Ultimately, increasing awareness of this often-debilitating condition contributes to reducing morbidity and mortality.