Intercostal myoplasty with thoracoplasty was performed in 42 patients with tubercular and bacterial empyema, after the failure of conventional therapy with antibiotics, antitubercular drugs and closed drainage. In the 18 cases with bronchopleural fistula, this was closed and the drainage tube was removed after 23 to 51 days. The procedure was well-tolerated by all the patients, and is safe and effective in patients with chronic empyema with or without bronchopleural fistula where resectional surgery or decortication is not possible due to extensive bilateral disease or low cardiorespiratory reserve. Successful ligation and closure of bronchopleural fistula without any mortality was a unique feature of this procedure.