One hundred and eight cases of empyema with and without broncho pulmonary fistula (BPF) were studied to analyse the efficacy of conservative management (aspiration/s and/or ICD). It was successful in 87.04% cases. Among those treated with intercostal drainage, the tube was removed within 2 months in 61.22%, 5 months in 71.42%, and 24 months in 85.71% cases. Only 14.29% cases showed persistent air leak even after 2 years of closed drainage. It was concluded that all cases of simple empyema and most cases of empyema with BPF can be managed successfully with conservative methods including aspirations and closed intercostal tube drainage.