A misplaced fine-bore nasogastric tube (NGT) might enter the bronchial tree. Pleural puncture and intrapleural passage of the tube is very uncommon but the location can often be inferred from the frontal chest radiograph. Following recognition of a NGT within the pleural space, progress films should be carefully screened for complications, particularly pneumothorax. This is often not done by staff involved in the monitoring of such patients because the staff frequently do not recognize the signs of intrapleural NGT insertion.