Introduction: We sought to find recurrence and overall survival in patients who underwent pericardiocentesis for malignant effusion. Methods: We identified consecutive 98 patients who were considered as malignant effusion and underwent successful pericardiocentesis (PCC) from Jan. 2001 to Sep. 2007. Recurrence was defined as need for PCC again or surgical drainage due to significant amount of effusion. Results: The mean age of the study population was 51.9 years and gender difference was equal. Adenocarcinoma of lung (ADC), squamous carcinoma of lung (SCC), and breast cancer were majority of cancer diagnosis (58.2%, 11.2%, and 10.2%, respectively). Fifteen patients (15.3%) underwent PCC at initial cancer presentation. Recurrent pericardial effusion was developed in 47.4% of patients with ADC. However, no recurrence of pericardial effusion was found in patients with SCC. In multivariate Cox regression, ADC (HR, 6.7; 95% CI, 1.8 to 24.8) were found as positive risk factor for recurrence, and response for systemic chemotherapy after PCC was negative risk factor (HR, 0.21; 95% CI, 0.08 to 0.59). In addition, patients with ADC showed higher survival rate than patients with SCC or other cancer, so six months survival rate was over 50% despite of higher recurrence rate of pericardial effusion (figure).