The question posed by the editorial staff at CHEST seems simple and straightforward, but unfortunately, its answer is complex. If a discreet dichotomous response is required, then our answer would be no. The essence of the question is small- vs large-bore chest tubes in the management of malignant pleural effusion (MPE). We contend that MPE represents a heterogeneous problem without a one-size-fits-all approach. Not all malignant effusions or the patients with them are the same, and much work needs to be done to sort out optimal management.