Abstract: Objectives: -Compare between pigtail catheter (12 Fr) and chest tube (28 Fr) in management of recurrent symptomatic malignant pleural effusion in patients who underwent chemical pleurodesis regarding 30-days effusion control rate, pain during insertion and pleurodesis and complication rate. Methods: -172 patients with recurrent symptomatic malignant pleural effusion included in this study were randomly distributed between two groups then underwent chemical pleurodesis by bleomycin then followed up after 30 days. Age, sex distribution and primary pathology were incomparable between the two groups. Results: -Group (1) experienced pain score measured by Visual Analogue Scale for Pain (VAS) during insertion 1.67 ± 0.72 while Group (2) had mean 3.82 ± 1.69 with (p value < 0.001), while pain during pleurodesis in Group (1) was 3.69 ± 0.78 while in Group (2) was 3.91 ± 1.16 with p value = 0.13,Recurrence during 30 days were 30.09 % in Group (1) and 37.68% in Group (2). Conclusions: -Chemical pleurodesis for recurrent symptomatic malignant pleural effusion by bleomycin via pigtail catheter in comparison to chest tube showed superior 30-day effusion control rate with less pain during insertion and pleurodesis with less complications apart from blockage