Pneumothorax is the accumulation of air in the pleural space. Pneumothorax may occur spontaneously (primary spontaneous pneumothorax, PSP). Chest tube drainage (CTD) is the most common choice for treatment of PSP. This study aimed to evaluate patients treated with CTD, regarding demographic and diagnostic characteristics, and to compare the effectiveness of apical and axillary approaches. We retrospectively analyzed a total of 217 patients with PSP regarding symptoms, duration of complaints, and treatment procedures. There were 196 (90.3%) male patients and mean age was 25.22 +/- 5.37 years. The approach of CTD was determined randomly; being performed with the apical approach on 93 (42.9%) and axillary on 124 patients (57.1%). There were no statistically significant differences between the two groups in terms of age, sex, BMI, collapse size, and complaint duration. However, a statistically significant relationship was determined between collapse size and leading symptoms where the significance was related to dyspnea (p < 0.001). This led to the thought that dyspnea increases with the increase of collapse size. The patients who were admitted to hospital in the later term when compared with others, had a larger collapse size (p < 0.001). This also led to the thought that collapse increases in relation to time due to late admission of patients. Hospitalization time was significantly shorter in patients who had apical CTD (p < 0.001). In conclusion, inserting the tube from the apex could shorten the treatment period.