Abstract: Objective: To explore the clinical value and safety of the pleural biopsy in the diagnosis of exudative pleural effusion.Methods: One hundred and eighty-three patients with pleural effusion of unknown reasons were treated with pleural biopsy,and the acid-fast bacillus and exfoliated cells in pleural effusion were detected.Results: The success rate of the taking sample though pleural biopsy was 90%.The pathological examination results showed that the obvious etiology in 112 patients were identified,the positive rate of which was 65.5%.Among 112 patients,the 40.9% of patients with tuberculous pleurisy was diagnosed,and the positive rate of tumor was 24.6%.During the 190 times of puncture,the pleural reactions in 8 cases(4.2%),and pneumothorax in 17 cases and no severe complications(such as chest infection or severe bleeding) were found.Conclusions: Pleural biopsy is simple,safe and effective,especially suitable for county hospitals.