Pleural effusion is defined as the presence of fluid in the pleural cavity. It has various causesranging from tuberculosis, bacterial empyema to congestive cardiac failure. The workup of such patients as a rule always begins with a good history, clinical examination combined with aspiration of the fluid and doing a detailed cytochemical analysis. Rarely some patients might present 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.