Emerging imaging tools and procedural techniques have refined the diagnosis and treatment of pleural diseases, including pleural effusion, empyema, pneumothorax, and malignant mesothelioma. Ultrasound-guided thoracentesis, pleural manometry, and indwelling pleural catheters are transforming patient care by reducing complications and enabling ambulatory management. Thoracoscopy remains a cornerstone for diagnosing unexplained effusions and administering talc pleurodesis. Pleural diseases research now focuses on molecular profiling of pleural fluid and minimally invasive biomarkers to improve diagnostic yield. Multidisciplinary input from pulmonologists, thoracic surgeons, and radiologists ensures accurate assessment and tailored treatment plans. Enhanced guidelines and procedural training are improving safety and outcomes across both inpatient and outpatient care environments.