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The centre's activities cover clinical work, research in clinical and epidemiological aspects of tuberculosis, training of medical and paramedical personnel, etc. The domiciliary treatment activities of the centre cover 7 municipal wards of Delhi city. The research activities of the Centre include epidemiology and chemotherapy trials. In keeping with tradition and reputation of its excellent work, a series of programmes have been drawn up to mark the occasion of the Golden Jubilee Celebrations of the New Delhi TB Centre. An Update on Tuberculosis and Respiratory Diseases has been fixed for October 29-30, 1990; a Refresher Course in Tuberculosis for general practitioners in collaboration with the Delhi Medical Association on October, 31st, 1990, and the main function will be held on 20th November, 1990, on which occasion a special souvenir is being released. 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There is ongoing debate regarding the best strategy to manage complicated parapneumonic effusion particularly regarding the role of antibiotic choice, drainage, intrapleural fibrinolysis and surgical intervention. Objectives To evaluate the outcomes of patients with complicated parapneumonic effusion with respect to different modalities of treatment. Methods A retrospective review was conducted on 63 patients with diagnoses of empyema thoracis or complicated parapneumonic effusion admitted between January 2003 to June 2005. Patients were recruited if pus was aspirated on pleural tap or pleural fluid results indicated complicated parapneumonic effusion. The clinical presentation and outcomes of this group of patients were analyzed and the risk factors associated with length of hospital stay, need for surgery and mortality were explored. Results The mean age of recruited patients was 64 16 year with a male to female ratio of 45: 18. The pleural fluid culture positivity rate was 68.3%. Among culture-positive specimens, 52.7 % were Gram positive pathogens. Overall, Streptococcus milleri 19.3% ; , Bacteroides 14% ; , Klebsiella pneumoniae 12.3% ; , Peptostreptococcus 7.0% ; , Escherichia.coli 7.0% ; were commonly isolated organisms. There were 13 deaths 20.6% ; noted in this review. Lack of drainage with intrapleural fibrinolytic p 0.007 ; and discordant initial antibiotic usage p 0.002 ; were independenty associated with higher mortality. Decrease in surgery-free survival was independently associated with discordant initial antibiotic usage. Prolonged hospital stay was associated with high APACHE II p 0.039 ; and female gender p 0.002 ; . Conclusions Discordant initial antibiotic usage was associated with poor mortality and surgery-free survival. Early drainage with intrapleural fibrinolytic appeared to be associated with improved mortality. A randomized controlled trial of early intrapleural fibrinolytics in complicated effusion or empyema thoracis is warranted. 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