During a 4-year period, 18 patients were treated for non-specific pleural empyema. Nine patients were treated by closed intercostal drainage and 9 by early decortication. The length of time from initial treatment until complete resolution of the empyema and healing of the wound was compared between the groups and highly favored early surgery. We conclude that if an empyema does not show signs of regression after one week of drainage, surgical intervention is indicated.