A 56-year-old man developed a V-segment liver abscess caused by the migration of a fish bone through the posterior wall of the duodenum, without abdominal pain or other gastrointestinal symptoms. The patient had recurrent fever lasting 25 days and increased inflammatory markers in the blood. Contrast-enhanced computed tomography showed a linear hyperdense structure from the duodenum to the liver parenchyma. An emergency laparoscopic procedure removed the fishbone, drained the abscess, and repaired the duodenal perforation. Postoperatively, the body temperature normalized on the first day, and the patient was discharged on the fourth postoperative day without recurrence. The case highlights the need to consider intestinal foreign body migration in patients with liver abscess and fever of unknown origin, even without abdominal pain. Accurate diagnosis requires a detailed dietary history and careful CT interpretation. Laparoscopic surgery is an effective diagnostic and therapeutic solution.