Thoracoscopy is minimally invasive diagnostic procedure done for the evaluation and diagnosis of pleural effusion. Pleural effusion is collection of fluid in pleural cavity. Pleural effusion can be because of wide variety of systemic or lung disorder. Very often despite fluid examination etiology of pleural effusion is not confirmed which is needed for correct treatment. In such conditions thoracoscopic examination of pleural cavity is very helpful in confirming the diagnosis. Thoracoscopy is minimally invasive technique in which is done under minimal sedation. A small incision is made on chest wall through which a small tube mounted with camera (thoracoscope) is passed in pleural cavity. If fluid is present in it, it is drained, and pleural cavity is inspected. If abnormalities are found, biopsy could be taken from pleural surface. If needed pleurodesis could be done. Following procedure an intercostal chest drain tube in placed in pleural cavity. This tube is usually removed with in 2 days. With introduction of thoracoscopy in clinical practice, evaluation, diagnosis and management of pleural effusion has become easy and much more precise. Any patient with exudative effusion which remains undiagnosed following initial evaluation should undergo thoracoscopy to determine the etiology of effusion. Those patients who have got malignant effusion, thoracoscopy provides effective means of doing successful talc pleurodesis.