Introduction:Chylothorax, a rare cause of pleural effusion, is the result of chyle leakage into the pleural space from the thoracic duct, with causes divided between traumatic and non-traumatic, with malignant and surgical trauma causes being the most common. A diagnosis is made following diagnostic thoracentesis, which reveals a transudative effusion per Light’s criteria, a fluid cholesterol level below 200 mg/dL, and a pleural fluid triglyceride level above 110 mg/dL [1]. Although rare, idiopathic chylothorax can be diagnosed after ruling out all other causes [2]. We present a case of idiopathic chylothorax diagnosed in a challenging patient.Case presentation :