Thirty-two patients with a known primary malignancy and a symptomatic malignant pleural effusion underwent small-bore-catheter thoracostomy and talc pleurodesis. Twenty-three patients (72%) had a complete response; four (12%), a partial response; and five (16%), no response. Symptoms in all those who responded were clinically improved. Complications included fever in 13 patients (41%) and moderate shortness of breath, chest pain, or both in six (19%). Small-bore-catheter thoracostomy and talc pleurodesis was successful in treating malignant pleural effusions.