A 59-year-old man with chronic pancreatitis and pancreatic pseudocysts presented a pleural effusion in the left thoracic cavity. Based on extremely high amylase levels in the serous effusion. Pancreatic pleural effusion was diagnosed. The chest radiograph showed reaccumulation of pleural effusion in the left thoracic cavity 4 months after drainage. As hemorrhagic pleural effusion had continued in spite of pleural drainage, octreotide therapy was instituted. Endoscopic retrograde cholangio-pancreatography (ERCP) showed irregularity of the pancreatic duct and leakage in the tail. Therefore, we diagnosed a pancreaticopleural fistula and an endoscopic nasopancreatic drainage (ENPD) tube was placed in the pancreatic duct to bridge the site of the irregularity. The chest tube was removed after chemical pleurodesis was performed. The ENPD tube was removed 3 weeks after the chest tube was removed. The fistula has not been proved to recur.