Malignant pleural effusion is a common problem in palliative care, observed in 15% of cancer patients, mainly in the course of lung cancer in men, breast cancer in women, and mesothelioma. This type of cancer complication is related to poor prognosis. Excessive fluid accumulation in the pleural cavity is caused by primary thoracic tumours or metastatic lesions in the chest and/or lymph nodes with destruction of lymphatic vessels, and also by cancer complications such as pneumonia or pulmonary thromboembolism. Relief of dyspnoea is the main goal in palliative care patients with malignant pleural effusion. Therapeutic thoracentesis is a treatment of choice; nevertheless, in some clinical situations more invasive procedures can be considered.