There has been considerable debate concerning the common practice of ordering a chest x-ray after having an intercostal tube removed. The indication for the x-ray was the removal of the tube, with the common justification being a look for any remaining or newly formed pathology. The research, namely studies of trauma and cardiac surgery patients, seems to contradict this idea. Reviewing the literature, we were unable to find any definitive research on the appropriateness of routine chest x-rays for post-operative thoracic surgery patients after intercostal tube removal. Patients and Methods: 120 patients fulfilled the criteria in the study were included in a prospective retrospective cohort study done at the Cardiothoracic Surgery Department at Zagazig University Hospitals, in the duration from January 2023 to August 2023 . Patients were divided into two groups. First group: Post- drain removal routine chest x ray and the second group: No Post- drain removal routine chest x ray, follow up patients done for 24 hours or developing any signs of respiratory distress or hemodynamics instability needing immediate performing new x ray for detecting of the need of new drain in the second group. Results: There was 60 patients in each group ,number of cases developed pleural pathology after drain removal were 2 patients (1.7٪) in 1st group and 4 patients (3.3٪) in 2nd group without statical significant difference between the two groups, number of patients need insertion of new drain was 1 patient (0.8٪) in 1st group and 1 patient (0.8٪) in 2nd group without statical significant difference between the two groups. Conclusion: as the presence of pleural space pathology after removal of chest tube is sporadic. so, routine chest radiograph after this maneuver does not increase clinically serious data for the patients, as CXR associated with increase in hospital cost and radiation exposure so, it should be done when clinically indicated only. So, patients safety and clinical outcomes were not affected by performing a post Intercostal tube removal CXR.