Neoplastic pleural effusion is one in which malignant neoplastic cells are detected in the pleural fluid or in the parietal pleura. When secondary, it confirms disseminated neoplastic disease and suggests a reduced life expectancy and low quality of life. This review was described by a group of physician members of the Brazilian Society of Oncological Surgery regarding the treatment of neoplastic pleural effusion, developed to guide surgeons, palliative care physicians and clinical oncologists in their clinical practice to assess patients indicated for pleurodesis based on survival scores.