Materials and Methods: A retrospective observational review study was conducted on 52 patients undergoing talc pleurodesis for hepatic hydrothorax between January 2020 and June 2025. Data included demographics, liver disease etiology, Child–Pugh class, MELD score, serum albumin, chest tube duration, hospital stay, recurrence, and complications. Quantitative variables were expressed as mean ± SD, and correlations were analyzed using Pearson’s r.

Results: Mean age was 61.2 ± 7.2 years; 67.3% were male. Hepatitis C was the leading etiology (96.2%), and 82.7% were Child–Pugh class C. Mean MELD score was 15.2 ± 5.4, correlating with both Child–Pugh class (r = 0.67) and recurrence (r = 0.63). Baseline albumin was 2.78 ± 0.44 g/dL, inversely related to recurrence (r = –0.39). After albumin optimization (>3.4 g/dL), the correlation disappeared (r = 0.02). Mean chest tube duration was 12.8 ± 7.3 days, hospital stay 4.6 ± 2.5 days, with a strong correlation between tube duration and recurrence (r = 0.67). Clinical control was achieved in 77%; pain (19.2%) and empyema (11.5%) were the main complications.

Conclusions: Talc pleurodesis offers effective palliation and significant symptomatic relief in refractory hepatic hydrothorax, especially where advanced therapies are inaccessible, improving quality of life for patients with end-stage liver disease. Keywords : hepatic hydrothorax, talc pleurodesis, cirrhosis, palliative management, recurrence