To describe the role of decortication and the outcome of the surgical treatment in childhood chronic pleural empyema, the charts of 100 children underwent decortication for the treatment of empyema were reviewed. The preoperative diagnoses were pneumonia in 46 patients, loculated empyema in 26, tuberculous empyema in 11, hydatid cyst in eight. Indications of decortication were severe pleural thickenning in 54 cases, trapped lung in 36 cases, loculated empyema in eight cases and bronchopleural fistula in two cases. Operations performed were decortication in 90 patients and pulmonary resection and decortication in 10. Morbidity occurred in 23 patients and one patient died. Success rates of decortication in the treatment of nonspecific and tuberculous empyema were 96,6% (86/89) and 90,9% (10/11), respectively. Decortication is a well-tolerated and succesfull procedure in childhood chronic pleural empyema.