Bilateral chylothorax is a rare complication of radical neck dissection and was first described in 1907. Stuart (1907) reviewed a number of patients with injuries to the thoracic duct in the neck and reported on three patients with bilateral chylothorax, all of whom died. The condition was not reported again until 1951 when the first of the five single case reports published to date appeared. The rarity with which this complication is reported makes it difficult for clinicians to be familiar with it. A further case is reported and the relevant literature reviewed, and certain aspects of the aetiology and management are discussed.