Pericardiocentesis, the percutaneous drainage of the pericardial effusion, is the technique of choice for the treatment of cardiac tamponade. In addition, it could be useful for diagnostic purposes in specific situations. The pericardial puncture could be associated to serious complications and as it could be performed in a wide variety of clinical settings, from an emergency to a programmed diagnostic procedure, it is mandatory for the clinician to know how to plan and how to safely perform the procedure. This chapter will deal with indications, contraindications, different approaches, complications and periprocedural management of the pericardiocentesis procedure.