Aim: To evaluate the efficacy of video-assisted thoracoscopic surgery (VATS) in the diagnosis and treatment of malignant pleural effusions (MPE) and to assess the results and complications of the procedure. Methods: A total of 61 patients with the diagnosis of malignant pleural effusion were assessed retrospectively between 2004 - 2010, 25 women (40.9%) and 36 men (59.1%), with an age range of 18-78 (mean: 61.3). Video-thoracoscopic surgery was performed under general anesthesia or with local anesthesia in sedated patients. Results: No intraoperative complications were observed. In 6 cases, prolonged air leak developed. Pleurodesis was successfully implemented in malignant cases. The chest tube was removed when the amount of fluid was less 50cc/24h. The duration of drainage was significantly shorter in patients in whom VATS was performed. Conclusion: We believe that VATS is an effective method in the diagnosis and palliative treatment of cases with malignant pleural effusions.