Pancreaticopleural fistula is an uncommon clinical entity that appears in patients with a history of chronic pancreatitis. Apropos of the case of a 40-year-old man in our hospital, we reviewed the literature and found 40 publications with little more than 100 patients. All of these publications highlight the atypical presentation with dyspnea as the first symptom and stress that diagnosis is based on magnetic resonance pancreatography. Endoscopic retrograde cholangiopancreatography is used in confusing cases and in planning the optimal surgical approach. Initial treatment should consist of conservative medical therapy, including total parenteral nutrition and somatostatin or its analogues. If the fistula persists or recurs, various options are available such as surgery, placement of a transpapillary pancreatic stent or nasopancreatic tube. The overall mortality rate from pancreaticopleural fistula is approximately 5%.