Empyema is an infection in the pleural space arising from a unilocular or multilocular collection of pus. It is the most common complication of pneumonia. This process can be insidious in nature and is a significant cause of morbidity and mortality, especially if the diagnosis is delayed. There are three stages which progress from exudative, fibrinopurulent, and organizing. Early processes are more amenable to drainage, whereas fibrinopurulent and organizing empyemas may require early surgical intervention. Therefore, it is important that risk factors for empyema are always kept in mind and management directed at obtaining source control is prompt if suspected.