Abstract: Malignant pleural effusion (MPE) is a common complication in cancer patients, and is associated with a poor prognosis. With increasing global cancer rates and prolonged life expectancy in most cancer patients, the incidence of MPE and its associated healthcare costs are expected to rise. Despite many palliative treatment programs for MPE, their effects are not definitive, and numerous challenges still exist in the clinical management of MPE. Pleurodesis, one of the main treatment methods for MPE, can effectively relieve the effusion-related symptoms and reduce the risk of repeat pleural interventions. In this article, we have reviewed the mechanism of pleurodesis in the treatment of MPE, the types of sclerosants, and methods of sclerosant delivery, to provide ideas for the development of an effective, reasonable, and personalized management strategy for patients with MPE in clinical practice.