Backgropund. Acute non-specific purulent-destructive lung and pleura diseases belong to the category of severe pathology in surgery. In spite of dramatic development of thoracic surgery the level of complications and mortality does not decrease and its complications lead to invalidism. Methods. We have studied modern literary sources on the topic of current trends in the treatment of acute pleural empyema and its complications. The studied material is summarized and presented in the form of a literature review in this article. Results. To improve the quality of treatment of patients in purulent-destructive lung and pleura diseases and their surgical complications an important role is played by objective formation of risk groups of developing complications and forecasting of the dynamics of the disease. Successful solution of the problem is related mostly to highly informative diagnostics, reliable determination of the severity of the disease, as well as creation of multidirectional classification of inflammatory lung and pleura diseases. Conclusions. These issues cannot be considered to be completely solved and require further study. Everything mentioned above dictates the search of new effective methods of the treatment of the mentioned pathology and proves the relevance of the theme. The outlined information highlights the necessity of improvement of surgical tactics in patients with pleural empyema.