An empyema is a pus-filled collection within the pleural space of the thorax that most commonly results from an untreated pneumonia. Additional risk factors include poor dental hygiene, malnutrition, immunosuppression, alcohol or IV drug use, and gastroesophageal reflux. Symptoms typically include a productive cough, fever, and pleuritic chest pain, and radiographic imaging is necessary for diagnosis.1In this case report, an adult male presented to the emergency department (ED) with a productive cough and shortness of breath. Ultrasound and computed tomography (CT) imaging confirmed the diagnosis of a left-sided empyema. The patient was successfully treated with a chest tube and antibiotics and was subsequently discharged eight days after admission. This case demonstrates the effectiveness of ultrasound and CT in diagnosing an empyema from other lung conditions. Ultrasound has the potential to visualize additional features not always seen on CT alone, which suggests the possibility of lung ultrasound as an alternative to a chest CT when diagnosing patients in at-risk radiation exposure groups, including children and pregnant women.TopicsEmpyema, lung ultrasound, chest tube.