Persistent air leak (PAL) is a management dilemma to many physicians, especially if it is associated with respiratory compromisation. PAL is associated with high morbidity, prolong hospital stay and higher cost of treatment. There are various ways to manage PAL, and traditionally surgery is known to be the most effective way to treat it. In the last decade or so, newer and less invasive methods were developed to especially treat patients who are unfit for surgical intervention. In this talk, both surgical and nonsurgical options to treat PAL will be discussed