ABSTRACT Parapneumonic pleural effusions may occur in 36–57% of patients with pneumonia and about 15–20% of this accumulated fluid becomes infected resulting in empyema [1,2)Empyema generally occurs in children after pneumonia of acute bacterial origin and it is generally associated with significant morbidity and mortality.Injection of various fibrinolytic agents like streptokinase, urokinase in the intrpleural space are increasingly being used for the management of such conditions.(7-10)The main aim of this study was analysing role of adding intrapleural streptokinase in the management of childhood empyema.Methodology:The present retrospective study was conducted in our Institute during a period of 2 years. The study consisted of 20 subjects that were admitted to the hospital with the complaint of pneumonia complicated by empyema.. Chest tube placement were done by pediatricians.Half of the patients received intrapleural streptokinase. The dose of streptokinase was 2,50,000 U in 100 ml of saline.The criteria for comparison were - duration of chest tube drainage, stay in hospital, fever and decrease in incidence of hospital stay were considered as successful treatment.All the data was arranged in a tabulated form and was analysed using Epi info software version 7.1.2. Chi square test and student t test was used for comparison. Probability value of less than 0.05 was considered significant. RESULT: The study enrolled total of 20 subjects, out of these 10 belonged to conventional group and 10 were administered intrapleuralstreptokinase.Both groups compared &There was no significant difference in the variables between the two groups as the p value was more than 0.05. CONCLUSION: From this study it is clear that addition of intrapleural streptokinase along with the conventional therapy provides no special benefit.In complicated cases fibrinolytics can be used as additional therapy.