Chylothorax is an unusual but serious complication of thoracic surgical procedures, and may carry considerable morbidity if not addressed in a timely fashion. Thoracic surgeons should be able to promptly diagnose this complication, and understand the implications of prolonged chyle loss to the patient. Conservative measures are often successful; direct intervention with percutaneous embolization of the cisterna chyli or thoracoscopic ligation is reserved for refractory cases. Some controversy exists regarding the timing of reintervention to limit the accumulated chyle loss. Prophylactic thoracic duct ligation has been examined but to date does not seem to reduce the incidence of chylothorax.