A 46-year-old male patient presented with high-grade fever, chills, hemoptysis, myalgia, acute onset of dyspnea, and right-sided chest pain. Emergency chest radiograph revealed right hydropneumothorax. On insertion of intercostal drain, there was a sudden gush of hemorrhagic fluid suggestive of hemothorax. There was no history of trauma or bleeding tendencies. Laboratory investigations revealed thrombocytopenia and positive dengue immunoglobulin M (IgM). The patient improved on aggressive supportive therapy. Subsequently, he underwent video-assisted thoracoscopic surgery (VATS) for non–re-expansion of lung. We report here a rare case of dengue hemorrhagic fever presenting as unilateral hemopneumothorax. Nontraumatic hemopneumothorax as an initial presentation of dengue is being reported for the first time in literature.