The charts of the patients underwent surgical treatment were reviewed to determine the role and the results of surgery in patients with tuberculous empyema. Two hundred eighty-two operations were performed in 222 patients. Indications of surgery were pleural thickenning in 95 (33,7%) operations, to close a pleural space in 92 (32,6%), destroyed lung plus empyema in 35 (12,4%) and revision of the first operation in 60 (21,3%) operations. Operations performed were thoracomyoplasty in 149 (52,8%), decortication in 95 (33,8%), decortication and pulmonary resection in 17 (6,0%), pneumonectomy in 10 (3,6%), decortication and thoracomyoplasty in eight (2,8%) and Eloesser flap in three (1,0%) operations. Morbidity occurred in 44,3% of the patients and operative mortality was 7,2%. Pulmonary tuberculosis and sequels of it determine the success of the operation in tuberculous empyema. Anti-tuberculous medication may be given for more than two months before the operation.