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Malignant pleural effusion (MPE) is characterized by the accumulation of fluid in the chest cavity, secondary to metastasis from a primary pleural tumor or malignant neoplasms originating from other anatomical sites. MPE is associated with a poor prognosis. Consequently, timely and effective prevention and management of MPE are critical. In Western medicine, the treatment of MPE primarily involves procedures such as surgical puncture for drainage, pleural fixation, chemotherapy, and targeted therapy. In contrast, traditional Chinese medicine (TCM) offers therapeutic modalities including oral decoctions, thoracic perfusion with herbal injections, topical applications of medicinal pastes, and acupoint therapies. The TCM approaches have demonstrated satisfactory clinical outcomes. Advances in the study of TCM for managing MPE in lung tumors are expected to yield a wealth of therapeutic strategies, facilitating the development of more optimized clinical treatments.