In summary, thoracoscopy offers several possibilities for diagnostic and therapeutic uses. Thoracoscopy helps in the diagnosis of pleural-based malignancy or tuberculosis with a high degree of accuracy when routine studies and closed needle pleural biopsies have failed. In patients in whom adequate visualization is possible, an unequivocal pathological diagnosis of benign diseases can be made with a specificity approaching 100%. Thoracoscopy is effective in the management of malignant pleural effusion and spontaneous pneumothorax.