A case of Aspergillus empyema with Aspergillus-related eosinophilic pneumonia is reported. A 51-year-old man was admitted with cough and high fever. Chest radiography and chest computed tomography showed cavitary lesions and extensive consolidation in the right upper lobe. A marked increase in eosinophils was seen in the peripheral blood and bronchoalveolar lavage fluid (BALF), and Aspergillus fumigatus was detected in BALF. This case was diagnosed as Aspergillus-related eosinophilic pneumonia. Antifungal drugs and systemic corticosteroids were administered, and his symptoms improved; however, he subsequently developed Aspergillus empyema with a pulmonary fistula. Chest tube drainage and another antifungal drug were started. The pleural fluid culture tests for fungus became negative. Despite chest tube drainage, air leakage did not cease. To control fungal infection and close the pulmonary fistula, a right upper lobectomy and decortication were performed. In follow-up, the patient had no clinical signs of recurrence, and this Aspergillus empyema was treated successfully.