Pleural diseases can be of infective , inflammatory or neoplastic origin . Pleural lesions contribute to a significant subset of thoracic diseases . Tumors of pleura are not uncommon and the diagnosis is clinched by combined clinical , imaging and histopathological evidence . Biopsy remains the gold standard for diagnosis . Metastatic malignant tumors of the pleura greatly outnumber the primary pleural tumors . The aim of our study is to identify the etiology of pleural based lesions at our center . Tuberculosis and malignancy are the most common etiologies encountered at our center. Although percutaneous pleural biopsy has high diagnostic value thoracoscopy is safe and effective procedure with both diagnostic and therapeutic value.