Sir,The recent report on “pleuroscopy in undiagnosed exudative pleural effusion” is quite interesting.[1] Prabhu and Narasimhan concluded that, “Pleuroscopy is a safe, simple, and valuable tool in the diagnosis of undiagnosed exudative pleural effusion with minimal complication rates.[1]” Indeed, the use of pleuroscopy can have both advantage and disadvantage. At least, this test is not an actual non-invasive test. With no doubt, this procedure should be the final choice for approach.[2] In this report, no serious complication could be seen, which might be due to selection bias. It has to be used by trained practitioners.[3] Despite manipulation by expert, the reported complication rate is still up to 5 %.[3]