A 35-year-old man received repeated treatments for alcoholic acute pancreatitis at a neighborhood clinic. However, hemoptysis and bilateral pleural effusion were observed; therefore he was hospitalized in our department. A chest CT revealed an emphysematous lesion with ground-glass attenuation in the right lower lobe and a cyst extending to the mediastinum from the pancreas. We believe the mediastinal pancreatic pseudocyst induced formation of a bronchopleural fistula that led to damage of the lungs subsequent to action of the pancreatic enzymes, ultimately resulting in hemoptysis. Mediastinal pancreatic pseudocyst is a complication of chronic pancreatitis. Pancreatic pleural effusion is known to occur as a result of mediastinal pancreatic pseudocyst, but there have been few reports on cases of hemoptysis, and there has been no reported case of damage to the lung with an emphysematous lesion.