In empyema thoracis, it is important to reduce the duration of treatment and to expand the collapsed lung as fully as possible while managing intrathoracic infection. We used thoracoscopy to treat 10 cases of empyema that were not completely cured by antibiotics or thoracic drainage. The 8 men and 2 women were 43-73 years of age. Thoracoscopy was done under general anesthesia except for 2 pneumonia patients. After inserting two trocars into the thoracic cavity, we removed pus, the purulent coat, and fibrinous membrane. Into one unilocular cavity, two intrathoracic tubes were inserted via trocarholes. Postoperative irrigation of the thoracic cavity was conducted daily through the two tubes. We subclassified the fibropurulent stage into three phases, namely, the purulent, fibrous, and purulent-capsular. One case required redrainage, but no cases were accompanied by severe complications or postoperative death. Patients were discharged on post-operative day 33, on average. We found no recurrence or cases of recollapsed lung during the study, from 8 months to 4 years and 11 months postoperatively.