An encapsulated pleural effusion is not an indication for mandatory surgery and needs to be determined on a patient-by-patient basis. The nature of the encapsulated pleural effusion needs to be determined. Generally, it is more likely that the encapsulated pleural effusion is tuberculous or pus-filled. If it needs to be determined, the pleural effusion must be extracted by thoracentesis for laboratory testing. If the test results suggest an exudate with straw yellow pleural fluid and a significantly elevated ADA level greater than 45 U/L, tuberculosis is considered more likely. However, if the pleural fluid extracted is a purulent, foul-smelling, grayish-yellow fluid with routine pleural fluid leukocytes greater than 10,000, it should be considered an abscess, which requires repeated flushing to help absorb the fluid. Tuberculous pleural effusion needs to be treated with anti-tuberculosis therapy. If the encapsulated effusion exists for a long time and the walls are thicker and cannot be absorbed by itself, and the amount of effusion is small and cannot be extracted, surgical pleural dissection is required. Surgery is usually considered only when the patient’s conservative medical treatment is not effective.