Lung abscesses commonly respond well to antibiotic therapy. In patients in whom conventional therapy fails, either percutaneous catheter drainage or surgical resection is usually considered but is frequently problematic. Endoscopic lung abscess drainage in selected patients is feasible and successful in experienced hands. This treatment represents an additional option for the chest physician other than percutaneous catheter drainage or surgical resection. This chapter describes the experience with endoscopic lung abscess drainage as an option in patients with antibiotic therapy failure.