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Background: Giant bullae (GB) are space occupying lesions associated with chronic respiratory symptoms. The aim of this study is to evaluate outcome of intra-cavitary tube drainage procedures (ITDP) in terms of clinical and radiological benefits. Methods: A prospective study was conducted in The Department of Thoracic Surgery, Jinnah Postgraduate Medical Center, Karachi, from February 2021 to April 2022 after ethical approval. Patients above 12 years, with poor reserve and GB underwent clinical, radiological and laboratory assessment before and after ITDPs to document various studied parameters. Results: A total of 48 patients were included; thirty-two (66.7%) were males. Mean age was 46.7±12.14 years. Most common aetiology was COPD (28; 58.3%). GB were ≥10 cm in size in 36 (75%) with right upper lobe involvement in 20 (41.7%). Preoperative dyspnoea score of IV was seen in 41 (85.4%) and chest pain in 42(87.5%) patients. In 34(70.8%) patients, Monaldi procedure and in 14 (29.2%) Brompton technique was used. Dyspnoea score improved from grade IV to II (24/41; p=0.004) along with reduction in pain and cough (p=0.012; p=0.002), respectively. Improvement post operatively in oxygen saturation, forced vital capacity, forced expiratory volume in 1 sec (6.08±1.36%, 0.73±0.516 L and 0.57±0.07 L, respectively, p