Summary Cleaning fill from wellbores is the most common coiled tubing (CT) application. The process is a function of multiple variables including fluid properties, flow velocities, wellbore geometry and deviation, pipe eccentricity, particle properties, fill penetration rate and wiper trip speed. Removing fill from wells with low bottom hole pressures (BHP) can be challenging especially if wells are completed with smaller diameter production tubulars which significantly reduce circulation flow cross-section and choke flow(1). Such challenges are further compounded by high deviation or horizontal well trajectories especially in large diameter wellbores. A variety of cleanout methods have been developed in the past, often incorporating high circulation rates, special fluids, wiper trips, or reverse circulation to remove solids. Many of these conventional sand cleanout methods often apply excess hydrostatic pressure on the formation, resulting in lost circulation in pressure depleted reservoirs. The conventional solution to overcome excess hydrostatic pressure has been to include nitrogen to reduce fluid density and thus lessen the hydrostatic head; however, sand vacuuming technology using a concentric coiled tubing (CCT) with a downhole jet pump is an alternative technique for removing fill without placing a hydrostatic load on the reservoir. This paper reviews the individual sand cleanout systems and discusses the advantages and limitations related to each method. In recent years, cleaning sand using the wiper trip method has become the preferred technique. However, an appropriate pump rate and reservoir pressure are needed to maintain a proper return flow rate to carry the sands to the surface. For pressure-depleted reservoirs completed with horizontal wells, a sand vacuuming system can be used to efficiently remove the debris without circulating nitrogen and without high pump rates. When the fill cannot be removed from large-diameter deviated wellbores using conventional low-cost cleanout fluids, then fluids with high solids suspension capability (under shear conditions) in conjunction with wiper tripping may be an economical option. The main application for the reverse circulation technique is cleaning sand from large diameter wellbores when the necessary pump rates for conventional "forward" circulation are not achievable. A venturi junk bailer is often used to retrieve larger or heavier material which cannot be circulated out by traditional methods. Field cases are provided, demonstrating how to select the proper cleaning method and how to efficiently remove sand from a wellbore based on both operational and logistical conditions.