Background: The cytological examination of pleural effusion is a very important test being easy, simple and obtaining pleural fluid by needle aspiration is considered the least invasive in diagnosis, prognosis and staging of malignant cases. It also gives information about various inflammatory and non-inflammatory lesions.Aims: This study aims to improve the technique of the cytological examination and to increase its diagnostic yield. Materials and methods: This study was conducted on 54 cases of pleural effusion cytological examination with the use of larger volumes, cell block, histochemical and immunohistochemical techniques. Results: Males were 53.7% and females were 46.3% with a median age of 50. The clinical impression in our cases was benign in 29.6% and malignant in 70.4%, while the cytology smears showed 64.8% benign cases and 35.2% malignant cases and histopathology of pleural biopsies of the same cases revealed 51.8% benign cases and 48.2% malignant cases. Fluid cytology smears showed sensitivity=61.5% and specificity=88%, while combined fluid cytology smears and cell block technique revealed sensitivity=69.2% and specificity=84%. PAS/PASD sensitivity =75% , Calretinin sensitivity =87.5% and CEA sensitivity =85.7%.Conclusion: Combined fluid cytology and cell block increased the sensitivity of diagnosis from 61.5% to 69.2% and it also gave a better cytomorphology and more cellularity with easier application of special stains and IHC which also helped obviously in diagnostic confirmation.