Background <p>Pleural empyema is an infection in the pleural cavity that usually arises from a&#xa0;parapneumonic pleural effusion. In most cases, the disease affects multimorbid patients and requires an interdisciplinary therapeutic approach.</p> Aim of the study <p>Processing of current scientific findings on treatment options for patients with pleural empyema.</p> Material and methods <p>Literature search on current study results and guideline recommendations.</p> Results <p>Pleural empyema can be classified into three stages in clinical practice. Stage&#xa0;I includes patients with an uncomplicated parapneumonic pleural effusion. In patients with a fibropurulent stage, bacteria or pus can be detected. In stage&#xa0;III there is a&#xa0;pleural fibrosis fixing the lung.</p> <p>Treatment is stage-appropriate and, in view of the patient’s comorbidities, ranges from relief of the effusion via puncture or chest drainage and the use of fibrinolytics to debridement of the pleural cavity and decortication of the lung. Special patient groups can also be treated via thoracostomy or vacuum therapy.</p> Discussion <p>The use of fibrinolytics to avoid surgical intervention is currently being discussed. Furthermore, thoracoscopic procedures should be favored over open surgical techniques.</p>