Aces of 51 years old women with lung carcinoma and cardiac tamponade is presented in this paper. A few days after lung transbronchoscopic, tachycardia, hypotension, tachypnea. Lungs X rays showed marked cardiac enlargement and she was referred to echocardiography, which revealed a large pericardial effusion with 2-D and Doppler signs consistent with overt cardiac tamponade. She was treated with echo-guided pericardiocentesis with extended catheter drainage and Tetracycline instillation before catheter removal. Next two, there was no effusion recurrence. An echo -guided pericardiocentesis with extended catheter drainage is safe and affective technique for pericardial effusion management in patients' malignancy.