Pleural effusion is defined as the presence of fluid in the pleural cavity. It has various causes-ranging from tuberculosis, bacterial empyema to congestive cardiac failure. The workup ofsuch patients as a rule always begins with a good history, clinical examination combined withaspiration of the fluid and doing a detailed cytochemical analysis. Rarely some patients mightpresent with loculated forms of pleural effusion which adds on to their diagnostic dilemma.We present a case of an apical loculated pleural effusion having a very interesting etiology.