SUMMARYThe case of a 36-year-old white man who had recurrent milky pericardial effusion and repeated pericardiocenteses over a period of 1 year with minimal disability or symptoms is presented. Surgical management included thoracotomy with ligation of all structures resembling lymphatic channels in the chest in several places and hemipericardiectomy. Neither the source of chyle in the pericardium nor the etiological agent of this condition could be found. Criteria for successful management of this condition are re-emphasized.