Empyema thoracis can produce significant morbidity in children if inadequately treated. Correct evaluation of the stageof the disease, the clinical condition of the child, and proper assessment of the response to conservative treatment is crucial indeciding the mode of further surgical intervention. The present hospital-based observational study was conducted in theDepartment of Cardiovascular and Thoracic Surgery, Government General Hospital, Guntur Medical College, Guntur. The studyperiod was from August 2017 to May 2022. Chest X-ray and Axial non-contrast computerized tomography (CT) scans were donein all the patients. All the patients underwent thoracoscopic decortication through Video-assisted Thoracoscopic Surgery (VATS)].The total number of patients with pediatric empyema thoracis during the study period was 56. Of these, 36 were males and 20were females, with the mean age being 5.6 ± 5.08 years. A surgical procedure was done under general anaesthesia and minimallyinvasive thoracoscopic decortication. All patients had lung expansion on discharge chest x-ray. The mean number of days ofhospital stay was 4.8 ± 0.8 days with no hospital mortality. Decortication appears to be a useful definitive treatment for childrenwith empyema thoracis in developing countries. Decortication emerges as a promising and effective therapeutic strategy foraddressing empyema thoracis in pediatric cases within developing countries. This surgical procedure, involving the removal of theinfected membrane surrounding the lung, demonstrates its potential as a definitive solution. Particularly relevant in regions withlimited medical resources, decortication exhibits its utility by offering a comprehensive approach to managing this condition. Byalleviating the burden of empyema thoracis in young patients, decortication not only contributes to improved health outcomesbut also showcases its significance as a valuable intervention in the context of healthcare disparities across developing nations.

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