Despite the availability of modern antibiotics, chronic empyema still presents as a most serious complication of pleural infection. Chronic encapsulations of purulent material can develop and persist even in the course of intensive antimicrobial therapy. Special problems are posed by the various empyemas, depending upon the completeness of encapsulation, the bacteriological etiology, the association of postoperative intrapleural space defects, and the presence or absence of a communicating bronchopleural fistula. Regardless of origin, most empyemas are curable. Aggressive, and, in many instances, radical surgical treatment of empyemas has in our experience, salvaged chronically ill patients, who in the past have been abandoned to a permanent bedridden sanatorium existence. To better evaluate the problem of chronic empyema, we reviewed all cases with this disorder seen during the past 12 years in our own practice and at the Cincinnati General, Veterans Administration, and Dunham Tuberculosis Hospitals. Both tuberculous and pyogenic empyemas were included