Bush thoracotomy is still practised in the South Western Highlands of Papua New Guinea, by traditional bush doctors. These bush thoracotomies are performed with the aim of letting out the 'bad blood' that is believed to have collected in the body cavities following injuries. During a 3 year period between 1989 and 1992, 183 patients with complications of bush thoracotomy were treated at the Sopas Hospital in the Highlands of Papua New Guinea. Of these patients, 55 had chest wall infections only, without any pleural involvement. Of the patients with empyemas, 14 were treated by decortication of the empyema with one death and all remaining patients were treated by drainage procedures with one death. We recommend early treatment by adequate drainage of the empyema and, where feasible, early decortication. Continuing education to eradicate the procedure, and provision of adequate surgical facilities for management of complications, should be the long-term aim for this continuing problem.