There was presented the experience of performance of videothoracoscopic pulmonary decortications in 22 patients, suffering suppurated clotted hemothorax, and in 188--an acute pleural empyema. In 97.3% patients the cessation of purulent process and pulmonary volume restoration were achieved. Residual cavities with the pulmonary nonairtightness signs were revealed in 3 (1.4%) patients, the empyema recurrence--in 1 (0.5%), suppuration of the wound, made by thoracic port--in 1 (0.5%), all the patients are alive.