Seven patients with postpneumonectomy empyema who had pulmonary carcinoma were treated with intrapleural antibiotic irrigation and closed chest drainage. Two tubes were used to irrigate and drain the cavity. Although most patients had a bronchopleural or esophagopleural fistula, the treatment was successful in every case. Three of the 7 patients died of advanced carcinoma 1-2 yr postoperatively, but none died of sequela of the empyema. In 3 patients with bronchopleural fistula, empyema recurred during the 1st postoperative year. It responded well to repeated irrigation and drainage. This simple, time saving and easily repeatable regimen was effective and also comfortable for the patient. It had none of the disadvantages of open thoracic drainage or mutilating thoracoplasty.