Chylous pleural effusion (CPE) is a milky pleural fluid that contains high levels of proteins, cholesterol, triglycerides, or chylomicrons. The main cause of CPE is disruption of the thoracic duct caused by traumatic or non-traumatic causes. High triglyceride, cholesterol, and/or chylomicron levels confirm the diagnosis. Recognizing the chyle leak site and underlying etiology is critical to the management of this clinical condition. There is no specific consensus on chylothorax treatment. However, a multidisciplinary (medical, surgical, and oncological) team approach is recommended.