Pleural effusion is a complication of bacterial pneumonia that is of particular importance because of its significant morbidity and mortality in children. The aim of this study was to investigate the clinical and etiological profile of pleural effusion in children. Medical records of children with pleural effusion who were followed up at University Faculty of Medicine between January 2012 and December 2022 were retrospectively evaluated. Clinical and etiological features, laboratory and radiological results, and treatment regimens of were noted. Medical records of 59 children (55.9% girls) aged between 7 to 216 months (median 100 months) have been noted. The etiology of pleural effusion was parapneumonic effusion in 37 children (62.7%), tuberculous pleurisy in eight children (13.5%). The most common bacterial pathogens were Streptococcus pyogenes, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Streptococcus pneumoniae and Haemophilus influenzae. In the early period of the COVID-19 pandemic, while cases of tuberculous pleurisy are decreasing, there is an increase in pleural effusions due to Streptococcus pyogenes. Medical treatment alone was given in 39% of cases, tube thoracostomy in 55%, thoracotomy and decortication in 18.6%. A 45.8% of children required pediatric intensive care unit stay. The median hospital stay was 12 days. Conclusion: Parapneumonic effusions due to bacterial agents are the most common cause of pediatric pleural effusions. In the early period of the COVID-19 pandemic, while cases of tuberculosis pleurisy are decreasing, there is an increase in Streptococcus pyogenes-induced pleural effusion/empyema.