Pleural empyema is defined as the pyogenic infection of the pleural space with purulent effusion. Although it is frequently seen in children and therapy protocols have been developed for it, there are only a few reports about pleural empyema in newborn infants. To our knowledge, just one preterm infant has been reported in the literature. In this article, we report an male infant born at 29 weeks of gestation who had pleural empyema on the 53rd day of life. Multidrug-resistant Pseudomonas aeruginosa (P. aeruginosa) was isolated from his pleural fluid culture. We suggest that this is the first preterm infant with P. aeruginosa empyema.