Background: One third of patients diagnosed with spontaneous pneumothorax may need surgery.1,2 There patients with significant comorbidities who cannot afford operation, blood patch pleurodesis (patients’ blood in thoracic cavity) may resolve the problem. Was noticed that can resolve also small air leaks post procedures in thoracic surgery like lobectomies, decortication.3 Methods: During the years 2017 -2021, seventeen patients, underwent blood patch pleurodesis at the Thoracic Surgery Department, General Hospital of Nicaea, Greece. Results: During the years 2017 -2021, seventeen patients (only one female) underwent blood patch pleurodesis, age 32- 84 mean age 67 years. An 82 year old male with significant comorbidities like heart failure very emphysematous lungs underwent blood patch pleurodesis 20ml the first time and a day after another 20 ml uneventfully. Another 83 year old male with significant respiratory failure and very emphysematous lungs, underwent blood patch pleurodesis 20ml autologous blood for three days successfully. He was discharged home with a valve and in a week time the chest drain was removed successfully with no recurrence. Three patients post surgeryfor spontaneous secondary pneumothorax (post pneumonia emphysematous lungs and heavy smokers) underwent successfully blood patch pleurodesis 30ml by the first time. There was another 32 old male operated for pneumothorax and post procedure he developed Covid 19. He underwent twice blood patch pleurodesis 20mls each day. He was discharged home with valve in quarantine for a week. Within a week post discharge ha was negative and his left lung was fully expanded and the thoracic drain was removed. Blood patch also was used successfully for five male patients who underwent decortication for mesothelioma and discharged home the sixth postoperative day. Another 73 year old male post decortication for empyema. Pleurodesis with blood was efficient for another five patients post lobectomy. Reduced the hospital stay at 6, 5, 4, 5 and 5 days for each patient. All above patients temperature was 37,5 and 38 C nocte and only once. Conclusion: Pleurodesis with blood is very useful for spontaneous pneumothorax treatment. Also is very helpful for small air leaks post thoracic surgery like lobectomies, decortication. Considered as alternative solution.