Objective：By analyzing the clinical characteristics of septic shock in patients of pyogenic liver abscess complicated with diabetes，we explored the early risk factors for shock prediction. Methods：We collected the clinical data of 240 diabetic patients with liver abscesses assessed by computerized tomography（CT）in the First Affiliated Hospital of Nanjing Medical University from January 2017 to April 2021. According to whether septic shock occurred or not during hospitalization，these patients were divided into a shock group and a non-shock group. The general information of patients at the first visit，symptoms，basic vital signs，abdominal CT and blood biochemical indicators，etc. were analyzed to identify the risk factors of shock. Results：①Comparing the general data of two groups， there was a significant difference in age（P < 0.05）. ②There were significant differences in respiratory rate，heart rate and maximum body temperature between the two groups of patients（P < 0.05），and the differences in mean arterial pressure and CT manifestations of absess were not statistically significant between two groups（P > 0.05）. ③Compared with the non-shock group，the white blood cell count and neutrophil count in the shock group were significantly increased，but the platelet count was significantly decreased. ④The prothrombin time，international standardized ratio of prothrombin time，partial thromboplastin activation time，and thrombin time were significantly prolonged in the shock group compared with the non -shock group（P < 0.05）. ⑤The binary logistic regression analysis showed that respiratory rate，maximum body temperature and prothrombin time were independent predictors of septic shock. Conclusion：The respiratory rate，maximum body temperature and prothrombin time of patients at the first diagnosis may provide important predictive value for the early identification of shock in patients with pyogenic liver abscess complicated with diabetes.