We here report two cases of tuberculous pleurisy complicated by abscess formation of the chest wall resulting from an indwelling thoracostomy tube. Both patients were diagnosed as having tuberculosis pleurisy by the pathological examination using the procedure of thoracoscopic pleural biopsy. The abscess of the first case was formed after the biopsy, and Mycobacterium tuberculosis was isolated, regardless of using antitubercular agents, from abscess of the chest wall where the thoracostomy tube had been placed. The abscess of the second case protruded into intrapleural space through the chest wall after the treatment of tuberculosis pleurisy. The paradoxical reaction was suspected in this case, since no organisms were isolated from the abscess specimens without additional antitubercular chemotherapy. It should be a concern that patients with tuberculous pleurisy have a risk of abscess formation of the chest wall resulting from placement of thoracostomy tube after thoracoscopic pleural biopsy.