Malignant pleural effusion (MPE) affects almost 15 percent of all cancers. It is burdensome and requires hospitalization in most of the time. It portends a poor prognosis. treatment should be personalized, focusing on patient centered goal mainly relieve of dyspnea and ultimately to improve quality of life. This talk will focus on the diagnostic algorithm of MPE and the therapeutic aspects of intercostal drainage, pleurodesis and specifically the role of indwelling pleural catheter (IPC) in our Malaysian setting.