Introduction : Pleural effusion is unusual amount of fluid that accumulates around the lung in pleural space_ Various conditions can lead to accumulate abnormal pleural fluid when the treatment target is likely  to drain it Aim : To study different causes and treatment modalities for patients of pleural effusion Materials And Method : In the institute during the period from May 2017 to April 2018, 80 patients studied with detailed history, lab investigations and treatment given documented. All patients followed short term approximately two weeks in detailed. Results : Tuberculosis was most common cause found other than malignant Para pneumonic effusion, C.C.F. anemia, hyperproteinemia ._ Conclusion : Most patients presented with signs and symptoms of cardio– respiratory distress. pleural fluid analysis is most important finding of diagnosis than FNAC in needed patients for confirmation of malignancy