Objective    To investigate the efficacy, advantages, disadvantages and application value of lateral femoral musculocutaneous flap free transplantation in the treatment of chronic refractory empyema.   Methods    From May 2015 to June 2021, 16 cases (including 13 males and 3 females) aged (51.19±17.42) years of chronic refractory empyema were treated with lateral femoral musculocutaneous flap free transplantation. The lateral femoral musculocutaneous flap was transplanted after full debridement of pus cavity. In 1 case, the lateral femoral muscle was transplanted in two sides, and the rest were transplanted in one side.    Results    During the follow-up of (20.94±8.27) months, 1 case died of tumor recurrence 6 months after operation, all the muscle flaps survived, and 2 cases of partial skin-flap necrosis were sutured directly after debridement. The abscess cavity was well filled in all cases. Postoperative pulmonary infection occurred in 1 case, which was cured after bronchoscopic closure of pleural fistula. None of the patients had symptoms such as chest tightness. The donor areas of the lower limb muscle flap were sutured directly and healed well. Walking function and knee joint activity were not significantly affected.    Conclusions    The  lateral femoral muscle has constant blood vessels, clear anatomy,  long and wide muscle shape and large volume, which can effectively fill the cavity formed by empyema and close the wound. This operation not only broadens the application range of lateral femoral musculocutaneous flap, but also provides a new choice for the treatment of intractable empyema.