Aims : To present all aspects of pleural disease, including 1) the pathophysiology of effusion formation and symptoms; 2) the optimal diagnostic methods, including emerging data on rationalisation steps and direct-to-biopsy strategies; 3) a synthesis of high-quality evidence that enables management of patients with malignant pleural effusion; 4) the evolving oncological management of mesothelioma; 5) pleural infection: from bench-to-bedside; and 6) a review of the optimal management of pneumothorax, including the results of soon to be published phase III trials of ambulatory/conservative strategies.