Malignant pericardial effusion is a potentially fatal complication of malignancy unless recognised and treated promptly. Patients with this condition are often difficult to diagnose. Physical examination, chest radiography and electrocardiography have poor diagnostic values in identification of patients with pericardial effusion. Echocardiography, which allows rapid confirmation of the presence of an effusion and precise assessment of its haemodynamic impact, is the gold standard for diagnosis.