While definitive data on pleural manometry are clearly lacking, we do believe that monitoring pleural pressures has a role during thoracentesis. We use manometry frequently when a diagnosis of unexpandable lung is suspected based on clinical, radiologic, and ultrasonographic data. However, arguing that manometry is mandatory during all thoracenteses does not appear justified in the absence of robust data on meaningful outcomes. Manometry has been adopted by a minority of proceduralists. Requesting that it be done systematically by all would, therefore, represent a substantial shift in management that has to be supported by strong evidence, no matter how “easy” or “low-cost” the procedure is. We would rather give priority to other interventions with proven efficacy, such as those listed previously.