Empyema is associated with significant complication and mortality. Intrapleural streptokinase has been used in empyemas with good success rate. Objectives of the study was to evaluate the efficacy and side effects of intrapleural streptokinase in the treatment of empyema. The results showed that the average duration of hospital stay, the average duration of chest tube were shorter in the intrapleural streptokinase group. Side effect: chest pain, fever, allegy were mild, hemothorax occurred 2 patients. In conclusion, intrapleural STK is safe and effective in the treatment of empyema, STK prevent pleural adhesions and reduce risks for surgery, reduce the average duration of hospital stay.