Hydro-pneumothorax is an abnormal collection of fluid and air in the pleural space.  The knowledge of hydro-pneumothorax dates back to the days of ancient Greece when the Hippocratic succussion was used to be performed for the diagnosis Generally patient with hydro-pneumothorax presents with heaviness of the chest with chest pain, shortness of breath, dry cough and early fatigue. The patient in this case report presented with the above complaints along with that he was having structural thoracic kyphosis and grade 3 gynecomastia. He was working in a diamond industry as a diamond polisher. This case explains the role of occupation and hormones on the presentation and prognosis of respiratory disease.