Objective: To examine the success rate of simple needle aspiration (SNA) for acute Bartholin’s gland abscess (ABGA). Design: Prospective cohort study. Setting: Academic Hospital of La Conception, Marseille, France. Population or Sample: Women who presented with AGBA between June 2013 and October 2017. Methods: The study cohort was subdivided into two treatment groups, SNA or incision and drainage (ID), according to their preference. Success was considered the absence of surgical treatment (failure treatment) within one month of the initial treatment. Recurrence was considered the occurrence of a new ABGA requiring surgical treatment (recurrence treatment) between one and 12 months after the initial treatment. Main Outcome Measures: Rate of women without failure or recurrence treatment after SNA. Comparison of success and recurrence rates between SNA and ID treatment for ABGA. Results: The rate of women without failure or recurrence treatment after SNA was 68/134 (51% (95% CI: 42-59%)). The success rate was lower in the SNA group than in the ID group: 93/134 (69%) versus 38/42 (90%) (relative risk [RR]: 0.77, 95% confidence interval [CI]: 0.66-0.89, p < 0.05). The rate of women without failure or recurrence treatment was similar in the SNA and ID group, respectively: 68/134 (51%) versus 25/42 (60%) (RR: 0.85, 95% CI: 0.63-1.15, p = 0.3). Conclusions: SNA can be offered as first-line treatment for ABGA. SNA can be performed as an outpatient procedure without anaesthesia and remove the need for secondary surgery in half of the cases one year post-treatment surgery.