Pleural effusion is a medical condition frequently encountered in various healthcare facilities. Several studies have shown that this condition is predominantly caused by tuberculosis (TB) as the underlying disease in tuberculosis-endemic countries. In case of massive pleural effusion, the underlying disease must be identified through pleural fluid analysis and radiological examination to provide appropriate interventions. Therefore, this case report presents an elderly male patient with massive pleural effusion caused by complicated TB. After thoracoscopy and snare electrocautery intervention, clinical recovery was experienced, with significant improvement on chest X-ray. Based on these findings, it is essential to consider interventional modalities to provide prompt and adequate management for affected patients.