Five patients with pericardial tamponade of neoplastic origin were treated by pericardiocentesis, drainage and local instillation of bleomycin. The pericardial effusion was adequately controlled in all patients. Survival was influenced not by the pericardial involvement, but by the natural evolution of the tumour. Side effects were minimal. The technique of drainage and bleomycin sclerosis is simple, safe, effective and inexpensive for the management of a malignant pericardial tamponade, providing all precautions necessary for diagnosis and pericardiocentesis are adequately taken.