Pleural effusions are frequently encountered conditions in pulmonary medicine. Pulmonologists commonly encounter patients with pleural disease like pleural effusion, pneumothorax, pleural wall thickening and pleural mass. Medical thoracoscopy also known as pleuroscopy is a safe and minimally invasive procedure in trained hands of pulmonologist which can be performed under local anaesthesia in an endoscopy suite. It allows to enter the pleural space, inspect it and perform limited diagnostic and therapeutic procedures like taking pleural biopsy from suspicious areas, adhesinolysis and chemical pleurodesis.