Medical thoracoscopy/pleuroscopy is considered to be one of the main areas of interventional pulmonology and should be included in the training programme of the chest physician. As with all technical procedures, there is a learning curve before full competence in medical thoracoscopy/pleuroscopy is achieved. Therefore, appropriate training is mandatory. This article describes the knowledge and skills required, the contraindications and potential complications and their prevention and the instruments used, as well as step-by-step information on how to perform medical thoracoscopy/pleuroscopy, which is even easier to learn than flexible bronchoscopy.