Background and Design.- Between 1993 and 1999, 47 patients with pleural effusions were treated by medical therapy and chest tube drainage in Paediatric Department of Zeynep Kamil Hospital. These cases were reviewed.Results.- The initial presentations in these cases were as follows: Empyema thoracis 20, parapneumonic effusion 20, tuberculous effusion 7. Only one patient with tuberculous effusion had required decortication. The mean hospitalization duration was 14.4 ± 6.2 days.Conclusion.- In our experience, most of the children with pleural effusions and empyemas can be treated by an effective medical treatment or by simple chest tube drainage. However, a few patients with persistent fever and respiratory distress may need further surgical interventions.* Anahtar Kelimeler: Ampiyem, Erken dekortikasyon* Key Words: Empyems, Early decortication