Background: Intercostals tube/catheter insertion is an invasive procedure usually done outside operating theater. If it is inserted without full aseptic technique, it will lead to a serious infective complication (EMPYEMA). A protocol of insertion must be designed, instructed and followed to do it safely to decrease rate of complication. All personnel involved in insertion of chest drain should be adequately trained and supervised. Objective: This study aimedto detect the compliance of chest tube insertion procedures with the standard Guideline and to detect the relation between, actual practice and occurrence of infection (superficial and deep). Methods: A descriptive prospective study-using auditing technique was conducted at Abbassia chest diseases hospital (one of the Ministry of Health hospitals with a total of 700 beds). Surgical and ICUs were chosen, a 119-inserted tubes were observed while they were introduced.  Those were of patients admitted during a period of 6 months. Results indicated that the infective complication was 66.4%, while complications other than infection were 33.6%.  The study discussed the relation between different practices as ; washing hands before the insertion, wearing personal protective equipment (PPE), using sterile tools, insuring sterility of dressing, avoiding touching environment while putting on sterile gloves  and the occurrence of infection (superficial and deep).