Background: Congenital chylothorax is an accumulation of chyle in the pleural space that may present in neonatal period with respiratory distress.
Case characteristics: A 34-week preterm who presented with massive congenital chylothorax complicated with hydrops fetalis.
Outcome: The neonate was treated successfully by pleurodesis with Oxytetracycline.
Message: Pleurodesis with oxytetracycline seems to be effective in treatment of congenital chylothorax.