ABSTRACT Purpose: is to compare wide pore with small pore chest drain in management of patients with malignant pleural effusion. Methods: this prospective study included 50 patients with malignant pleural effusion attended to cardiothoracic department at Benha university hospital during 2017. Patients were divided into two groups; group A which comprised 25 patients who underwent insertion of wide pore chest drain and group B which included 25 patients who underwent insertion of small pore chest drain. Both groups were compared in terms of efficacy, safety and complications. Results: the study included 24 males and 26 females. The mean age of patients at intervention was 53 ±12 in group A and 53 ±13 year in group B. Initial drainage in group A was 1012±369 cm3 compared with 960±355 cm3 in group B (P= 0.614 ). Average drainage was 496 ±188 cm3 in group A and 354±167cm3 in group B (P=0.007). The rate of complications in the form loculation and wound infection was found more significant in group A relative to group B (P=0.24 and 0.23, respectively). Conclusion: Small pore chest drain was found more effective with fewer complications relative to large pore one in management of malignant pleural effusion.