Abstract: Objective To summarize the experience in treatment of 42 cases of tuberculous empyema accompanying bronchopleural fistula with combined Chinese traditional and Western medicine. Methods The 42 cases were treated with transthoracic closed drainage,removal of pleural tuberculous foci,resection of extra-pleural lung lobes and total pneumonectomy,followed by compress or oral medication of traditional Chinese herbal drugs. Results Thirty-eight cases were completely cured after the treatment with a clinical effective rate of 90.5%（38/42）,and 4 cases were improved with no death occurred. Conclusion Surgery is one of the effective treatment modalities for tuberculous empyema accompanying bronchopleural fistula.Better results can be achieved when surgery is combined with compress and oral medication of traditional Chinese herbal drugs.