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The diagnosis of chylothorax during pregnancy is rare and is generally triggered during labor. The study of pleural fluid and imaging studies can facilitate diagnosis, even though determining its etiology can be complicated. This case involves a young pregnant woman presenting with disabling dyspnea and chest pain due to pleural effusion. The conventional study of the pleural fluid was not conclusive; however, the measurement of chylomicrons guided us to determine the diagnosis of chylothorax. Based on imaging studies and specific markers, some of the main etiologies were not determined, leading to classification as idiopathic. After drainage and dietary adjustment, a significant improvement in symptoms was achieved with the help of an interdisciplinary team, which is crucial for the prevention of complications and adequate resolution of the pregnancy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Martínez Camacho et al.)