Background: The optimal initial management of primary spontaneous pneumothorax (PSP) remains controversial.
Aim of the work: Evaluation of the safety and efficacy of intrapleural iodopovidone following intercostal tube drainage for initial treatment of PSP.
Patients and Methods: Between June 2010 and June 2014,64 patients with documented first time primary spontaneous pneumothorax were enrolled in this study after obtaining informed consents. They were divided into two groups; Group 1 (control group) were 24 patients have PSP first time and managed by intercostal tube drain without pleurodesis, and group 2 were 40 patients have PSP first time and managed by intercostal tube drain with iodopovidone pleurodesis (20mL of 10% iodopovidone hydrochloride).
Results: There was no significant difference between the two groups in terms of demographic data. Also, hospitalization rates and mean hospital stays had no significant difference between both groups. Patients in the iodopovidone group had higher doses of pethidine injection. After a mean follow-up of 9 months (range6-12 months), recurrence was noted in one patient (2.5%) of the iodopovidone group and 7 patients in the control group (29.2%).   
Conclusion: Intrapleural iodopovidone following intercostal tube drain is a simple, safe and convenient initial treatment for PSP thatreduce the rates of ipsilateral recurrence but associated with significant controllable chestpain.