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Autologous blood patch for persistent air leak in pneumothorax is efficacious, readily available, cheap and well tolerated However, there is a need for optimising the approach to autologous blood patch and establishing its efficacy and safety in controlled trials. Prolonged air leak after pulmonary surgery remains a clinical challenge and sometimes needs surgical reintervention An autologous blood patch (abp) may provide a noninvasive method to stop air leak Its value, however, is debatable. Upsize chest tube under fluoro guidance as needed (minimal size of chest tube 10fr) proceduralist will withdraw 100 cc's of blood (with the 60 cc syringe) from patient and instill into pleural space via chest tube An autologous blood patch is a procedure where blood is collected from one of your veins This is then injected into your chest cavity through the chest drain that is already in place. Blood pleurodesis has been used to treat pneumothorax and persistent postoperative air leak following pneumonectomy However, the indications for this procedure and the exact technique to be followed remain poorly defined. We report two cases in which patients with a prolonged air leak who were not candidates for thoracotomy had immediate successful treatment with an autologous “blood patch” pleurodesis. Blood patching is an efficient, safe, and effective technique that anecdotally decreases the risk of air leakage from the puncture site The interventionalist draws a few millimeters of blood directly from the patient's iv, anywhere from three to ten depending on the depth of the lesion. Persistent air leaks were catalogued twice daily according to the classification previously reported by cerfolio and associates. Direct application of a clot allows for the fibrogenic activity of a patient’s own blood to create a seal by irritating the pleura and causing an inflammatory cascade to ultimately seal the air leak.