A 51-year-old man with chronic alcohol-related pancreatitis was admitted to our hospital complaining of hemoptysis. A chest X-ray film revealed a ground-glass opacity in the left lower lung field and a bronchoscopic examination revealed bleeding from the left lower lobe bronchus. Chest multi detector-row CT demonstrated a cystic mediastinal mass along the esophagus from the pancreatic tail reaching the carina. No pleural effusion was found. Based on the clinical and radiographic features, we diagnosed mediastinal pancreatic pseudocyst. After four weeks of the treatment of pancreatitis with total parenteral nutrition, hemoptysis was disappeared and the serum amylase level normalyzed. The follow-up CT scan showed that the cystic mediastinal mass had disappeared completely. Mediastinal pancreatic pseudocyst accompanied by hemoptysis is very rare. We suggest that mediastinal pancreatic pseudocyst also should be considered in the differential diagnosis of alcoholics with hemoptysis.