Background: The presence of malignant cells in pleural fluid or pleural tissue is called malignant pleural effusion (MPE). Lung cancer, breast, ovary, and lymphoma are responsible for malignant pleural effusion by more than 75%. Pleurodesis is a common method for managing malignant pleural effusion to generate a symphysis between parietal and visceral pleura. Aim and objectives: The aim of this study is to evaluate the safety, efficacy and the success rate of 10% povidone-iodine in pleurodesis procedure through thoracostomy by conducting the objectives which were assessment of radiological outcome after using of povidone-iodinee as a chemical pleurodesis, assessment the adverse event and clinical outcome after using of povidoneiodinee as a chemical pleurodesis and evaluation the effect of povidone-iodine on thyroid function test. patients and methods: this is randomized clinical trial, was carried out on 24 cases at Cardiothoracic Surgery Department, Zagazig and Tripoli University Hospitals, all patients, who underwent pleural drainage and received bedside pleurodesis with 10% povidone-iodine, Pleurodesis efficacy was defined in three response levels, 1)symptomatic improvement of dyspnea with complete radiographic resolution of the pleural effusion till the end of follow up as "complete response"2) symptomatic improvement with recurrent pleural effusion that did not need additional thoracentesis as "partial response" ,and 3) recurrent pleural effusion that needs further thoracentesis as "treatment failure" . Results The results revealed that Early response was 70.8% complete response, partial response in 25%, and failure 4.2%, the major complication was need of analgesia, regarding follow up successes (complete and partial) 87.5% and failure 12.5%. Conclusions: Povidone-iodine is shown to be a safe and effective agent with few adverse effects in pleurodesis of patients with malignant pleural effusion can be used as a low cost and accessible alternative to other chemical sclerosing agents.