Background <p>Malignant pleural effusion (MPE) is a significant cost of burden and carries a poor prognosis with a median survival of 3–12&#xa0;months. Indwelling pleural catheters (IPC) have been shown to be effective in improving symptoms in patients with MPE. This study reports our 5-year real-life experience with IPC in patients with MPE from a hospital with a dedicated pleural service in the Republic of Ireland.</p> Methodology <p>This is a retrospective, single-centre study based in a tertiary hospital. All patients who had IPC inserted by the pleural service in a 5-year period (1st of January 2019 until 31 December 2023) were included in this study. Patients’ clinical details and histology results were acquired via the hospital’s electronic medical records.</p> Results <p>During the 5-year period, there were 55 patients who had IPC inserted. Symptom improvement was achieved in almost all patients (<i>n</i> = 54, 98.2%). Our total complication rate was low at 14.5% (<i>n</i> = 8), with the majority being catheter-associated skin infection. Pleurodesis was achieved in 21 (47.8%) patients with the mean and median time to pleurodesis were 115.5&#xa0;days and 94&#xa0;days, respectively.</p> Conclusion <p>IPC is a relatively safe procedure with low complication rates when performed by trained physicians. The additional support of a dedicated pleural service will maximize the benefits of IPC while reducing the complication rates<b>.</b></p>