Chest tubes are utilized for a variety of reasons, ranging from emergent placement to routine use after surgery. It is not uncommon for nurses to encounter a patient with a chest tube at some point during their career; in most cases fairly frequently if working in the perioperative environment or surgical patient care unit. Therefore, it is essential for nurses to feel comfortable with chest tube management as it is critical to the patient’s overall health. In recent years, there have been developments and modifications to thoracostomy tubes and it is imperative that nurses are familiar with the indications and principles of safe chest drain management. This educational activity will provide nurses with an understanding of the basic anatomy and physiology related to conditions requiring chest drainage. An overview of the types of chest drains, indications for effective use and key management factors will be described. The safe and effective use of chest drainage systems will be discussed so that nurses can provide high quality care for their patients to achieve optimal care outcomes.