Abstract Background: Medical thoracoscopy is performed under local anesthesia and conscious sedation. It has a very high diagnostic yield with fewer complications and offers oppor-tunity to perform concurrent pleurodesis. Aim of Study: The aim of this prospective study is to compare thoracoscopically obtained parietal pleural biopsies by rigid forceps and cryoprobe biopsies during medical thoracoscopy in patients with exudative pleural effusion. Patients and Methods: The study included 50 patients have undiagnosed exudative pleural effusion (clinically, laboratory and radiologically); all were admitted in Al-Hussein University Hospital in Chest Department, fifty patients were implemented to medical thoracoscope after written consent. Results: Comparing between Rigid forceps and Cryoprobe biopsies as regard number of biopsies revealed highly statistical significant difference (p-value <0.001) between Rigid forceps and Cryoprobe biopsies as regard number of biopsies (170 Rigid forceps, 96 Cryoprobe). The most common definitive diagnostic results were malignant mesothelioma (32) 64% (26 Epithelial type 52%, 6 dysmoplastic type 12%). Conclusion: Pleural cryobiopsies through rigid thoracos-copy is a simple and safe procedure. It has a high diagnostic yield similar to rigid forceps biopsy. Biopsies using cryoprobe are now widely used in interventional pulmonology.