A Cross Sectional study was carried out on 100 patients with pleural effusion from December 2013 to July 2015 at ASRAM Medical College and Hospital Department of Pulmonary Medicine,Eluru. In our study, Exudative effusion remains most common cause of pleural effusion.Tubercular effusion remains the commonest etiology of all exudative effusions, where as Congestive cardiac failure remains commonest cause among transudative effusions.Tubercular effusion affects most commonly young and is associated with cough and fever as the most common presenting symptom. Malignant effusions were seen in older age group with cough and dyspnoea as predominant symptoms.Massive effusion with hemorrhagic pleural fluid is commonly associated with malignant effusion while small to moderate effusions with straw colour pleural fluid is associated ubercular effusion where as empyema cases presented with pus. Right sided effusion was most common with male to female ratio of 3.54:1 ,with mean age of 40.5+11.3 years.Empyema was most commonly associated with high Leukocytes.Tubercular effusion was associated with lymphocytic predominant effusion where as neutophilic dominant effusion included empyema and parapneumonic effusion.Pleural fluid, with low glucose (<40 mg/dl) was seen predominantly in empyemas. Pleural LDH to serum LDH ratio >2 was seen predominantly in empyemas .A pleural fluid ADA more than 70 IU/L was associated with nearly half of Tubercular effusions , where as others with ADA levels between 30 to 70 IU/L along with clinicoradiological findings suggestive of tubercular effusion. Thus proving diagnostic importance of ADA in TB effusions.Early intiation Anitubercular drugs in TB pleural effusion, early intervention and treatment in cases of empyema and parapneumonic effusion showed improvement and signs of recovery.