The search for the ideal agent to achieve pleurodesis for malignant pleural effusions is still on. Twenty-two patients with dyspnea-producing, recurrent pleural effusions secondary to epithelial neoplasms were subjected to instillation into the pleural cavity of either iodopovidone (14 patients) or bleomycin (8 patients) through a large bore chest tube. The results showed that in 9 of the 14 patients receiving iodopovidone (64.2%) and in 7 of the 8 patients in the bleomycin group (87.5%) there was no further need for drainage of the pleural space. Local or systematic complications occurred in 8 patients; no complication was severe. In conclusion in this preliminary study, iodopovidone has shown promise as an effective, readily available and inexpensive alternative to achieve chemical pleurodesis in cases of recurrent, incapacitating effusions secondary to malignant epithelial neoplasms; further studies are needed to confirm these initial results.