Pleural effusions are associated with a number of medical conditions causing fluid accumulation via differing synergistic mechanisms including increased pleural membrane permeability, increased pulmonary capillary pressure, decreased oncotic pleural pressure, and lymphatic obstruction. Pleural fluid analysis yields important diagnostic information in most cases of pleural effusions, biological parameters including pleural matrix metalloproteinase (MMP) levels are markers elevated in the pleural fluid from effusions compared with malignant and other benign settings. The aim of this study was to explore the clinical validity of matrix metalloproteinase 2 (MMP-2), MMP-9 and tissue inhibitor of metalloproteinase 1 (TIMP-1) in discriminating between the tuberculosis pleural effusion and malignant pleural effusion, and also to investigate the serum levels of these enzymes in both diseases. Results: Showed increase levels of MMP2.9 and TIMP1 in serum of patients with active, old TB and Malignant cases than control (P