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The loss of a guidewire occurs very rarely during central venous catheterization (CVC). Guidewire loss can lead to serious mechanical, thrombotic, and infectious complications. A 74-year-old woman was admitted to our institution with dyspnea. Chest computed tomography revealed a guidewire that had remained in a central vein for 3 years, and the patient had extensive central venous thrombosis and a chylothorax. The guidewire and venous thrombus could not be removed because of high perioperative risk due to adhesions and chronic atrophic changes of the intravascular layer. The chylothorax was resistant to conservative treatment. Therefore, the patient was subjected to thoracic duct ligation and embolization. Subsequently, the chylothorax disappeared and the patient was discharged. Physicians should be especially aware of the adverse effects caused by a remnant guidewire and the need for simple chest radiography after CVC.