Increasing incidence of pleural infection has been reported worldwide in recent decades. The pathogens responsible for pleural infection are changing and differ from those in community acquired pneumonia. The main treatments for pleural infection are antibiotics and drainage of infected pleural fluid. The efficacy of intrapleural fibrinolytics remains unclear, although a recent randomized control study showed that the novel combination of tissue plasminogen activator and deoxyribonuclease had improved clinical outcomes. Surgical drainage is a critical treatment in patient with progression of sepsis and failure in tube drainage.