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BACKGROUND: Loculated pleural effusions present as a challenging clinical scenario due to the formation of loculations, often leading to increased morbidity and prolonged hospital stays. Intrapleural Streptokinase(STK) has been proposed as a potential therapeutic option to facilitate pleural adhesiolysis and improve pleural fluid drainage in these cases. METHODOLOGY: Designed as an analytical study in a prospective manner. Conducted from July 2022 to June 2024 at Government Chest Diseases and TB Hospital, Hanamkonda, Warangal. 30 patients having loculated pleural effusions were included in the study. All the cases were evaluated with detailed history, examination, blood workup, pleural fluid analysis and after informed written consent, all the cases were given Intrapleural streptokinase at a dose of 2,50,000 IU per day for 2 - 7 days. Patients were assessed based on amount of pleural fluid drained before and after instillation of streptokinase, improvement of chest x ray and ultrasound clearance of loculations. All the patients were carefully monitored for the possible complications. RESULTS: In 73.3% of the patients there is complete lysis of adhesions and drainage of pleural fluid with the use of intrapleural streptokinase. [ABSTRACT FROM AUTHOR]