A 68-year-old man was admitted to our hospital for investigation of pleural effusion. He had medical histories of alcoholic liver cirrhosis and hemodialysis. A thoracentesis yielded fluid with characteristics consistent with chylothorax, even though the pleural effusion was transudative. There was no apparent causative disease for general investigation. Irrespective of treatment, including dietary fat restriction and pleurodesis with OK-432, the effusion did not reduce. This patient had coexisting ascites, and we performed paracentesis on ascitic fluid. The analysis showed the same characteristics of pleural effusion. Therefore we diagnosed this patient as having liver cirrhosis complicated with chylothorax. β-Blocker was very effective, and the pleural effusion disappeared after antiportal hypertension therapy. Chylothorax is a rare and underappreciated manifestation of liver cirrhosis. The biochemical characteristics of cirrhotic chylothorax of a transudate are useful for diagnosis.