Pleurodesis is an effective palliative procedure to control a malignant pleural effusion. In patients with suspected malignant pleural effusion, a pleurodesis, gives the opportunity to establish a definitive diagnosis as well as to control the recurrence of the pleural effusion. However, as with all surgical procedures, the benefits must be weighed against the risks of the operation.Wehypothesised that lowserumalbumin levels were associated with poor survival after pleurodesis and therefore studied the pre-operative serum albumin levels as a predictor of poor long-term survival. A retrospective audit was conducted of all patients undergoing a pleurodesis for malignant pleural effusion between July 2007 and January 2013 at The Canberra Hospital. A total of 326 patients were identified. Patient datawas analysed including histology, preoperative serum albumin and length of survival following the procedure. Patients were grouped according to their preoperative serum albumin levels and their post-operative survival time in days. Patients with low (under 33) and very low (under 25) serum albumin were found to have survival times under 3 months and under 1 month respectively which were found tobe statistically significant (OR3.460, P=0.0136 andOR 13.8, P=0.0008). In view of these findings, we believe that serum albumin levels can be used as a simple predictive factor in decision making. In patients with very low serum albumin levels, an indwelling pleural catheter may be offered as a simpler palliative alternative.