To explore the clinical characteristics, diagnosis and treatment process of liver abscess and hemolytic anemia caused by Clostridium perfringens (Cp) infection in diabetes patients, and improve the awareness, diagnosis and treatment of patients. Clinical data of a diabetes patient with liver abscess, hemolytic anemia, bloodstream infection and multiple organ failure caused by Cp infection in a hospital in August 2022 were analyzed. Retrospective analysis of the data was conducted in combination with relevant literatures. A total of 19 English literatures were retrieved. Combined with the case in this study, 20 patients were included in the analysis, 10 were males and 10 were females, with an average age of 70.7 years, 12 patients complicated with diabetes. Clinical manifestations of the patients lacked specificity, and all patients had varying degrees of hemolytic anemia. Seventeen patients (85.0%) died, with an average time of 23.84 hours from seeking medical advice to death. Fourteen of them (82.4%) died before a clear pathogenic diagnosis was made, and 11 (64.7%) died within 8 hours of admission due to ineffective rescue efforts. There were only 3 survived patients, all of whom had obtained pathogenic results at the early stage of the disease: two patients underwent liver abscess puncture and drainage at the early stage, while the other patient's liver abscess ruptured into the liver capsule during treatment, and the lump shrank. Cp-infected liver abscess complicated with hemolytic anemia progresses rapidly, and has a high mortality at early stage, making early diagnosis especially important. When Cp infection is suspected, pathogenic diagnosis should be rapidly confirmed through Gram-staining or next-generation sequencing of puncture fluid/blood, so as to alter patient's survival outcome through early adjustment of sensitive antimicrobial agents and clearance of infected lesions.