The invasive procedures handled by the pulmonologist in the diagnosis of lung disease have greatly expanded over the last decade (transbronchial, percutaneous or thoracoscopic pulmonary biopsy and needle aspiration). The growing number of intensive care units with facilities in mechanical ventilation and hemodynamic support has also modified the approach of the critically ill patient. Pneumothorax and hemothorax are well-known complications related to these diagnostic and therapeutic techniques. Other areas of interest and up-to-date are diagnostic thoracoscopy in pleural disease, chemical pleurodesis in patients with pneumothorax or malignant pleural effusion, and the administration of intrapleural fibrinolytics in the treatment of empyema. This evolution implicates that the pulmonologist and the intensivist be skilled in the management of chest tubes. In this article we review the indications, some technical topics and the principal complications related to the placement of thoracic drains.