Background: Tube thoracostomy is defined as insertion of a tube (chest tube) into the pleural cavity to drain air, blood, bile, pus, chyle or other fluids The present study was conducted to compare tube thoracostomy in triangle of safety versus outside the triangle of safety. Material and methods: This study was multiple centre prospective comparative study conducted in department of Surgery. A total of 69 patients were included in study, randomized into two groups, tube thoracostomy in safe triangle (n=35) and tube thoracostomy outside safe triangle (n=34). All cases were carefully worked up in terms of detailed history and clinical examination. Lab and imaging intervention included. Results: It was observed that major lung conditions for which the tube thoracostomy done in triangle of safety, improved rapidly and earlier in comparision to tube thoracostomy done outside the triangle of safety. Pneumothorax, Hemothorax, Hemopneumothorax, Empyema, Chylothorax, Hydrothorax and Pleural effusion improved rapidly and earlier when tube thoracostomy was done in triangle of safety. However, group of patients having similar indications for tube thoracostomy but done outside safety triangle, improved slowly and delayed. It was observed that major complications of tube thoracostomy as either technical or infective. Technical complications include –Tube malposition, Blocked tube, Chest drain dislodgement, Reexpansion pulmonary oedema, Subcutaneous emphysema, Nerve injury, Cardiac and vascular injuries, Oesophageal injuries, Fistula, Tumor recurrence at insertion site, Herniation through the site, Chylothorax and cardiac dysrhythmia. Infective complications include Empyema and Surgical site infection including cellulitis and necrotizing fasciitis. All above mentioned complications except few one were more frequent when tube thoracostomy was done outside safety triangle in comparison to tube thoracostomy in triangle of safety. Tube malposition is the commonest complication of tube thoracostomy. Intraparenchymal tube placement occurs more likely in the presence of pleural adhesion. Blocked tube may be due to kinking, angulation or clot formation. Subcutaneous emphysema associated with trauma, bronchopleural fistula, large and bilateral pneumothoraces, prolonged drainage and tube blockage. Conclusion: Tube thoracostomy, though commonly performed is not without risk. It has been seen that, there is not only rapid recovery but least chance of complications, when tube thoracostomy done in triangle of safety in comparison to tube thoracostomy done outside triangle of safety.