BACKGROUNDPersistent pleural effusions pose a diagnostic challenge and need extensive workup to come to a conclusion. Pancreaticopleural Fistula (PPF) is one of the rare causes for persistent massive pleural effusions (1-5). It is seen especially in patients who are alcoholic and with a history of pancreatitis. We report a case of persistent pleural effusion resulting from a pancreatic pse udocyst communicating with pleural cavity in a patient with past history of pancreatitis.