A case of progressive pleural effusion in a 50 year-old woman is presented. She had a history of recurrent bilateral symmetric joint affection involving small and large joints in the extremities and morning stiffness. Extraarticular manifestations developed after two years' disease; mesangial proliferative glomerulonephritis, Sjogren's disease and progressive pleural effusions. The diagnosis rheumatoid pleural effusion was based on the history of articular disease, blood samples, examination of the pleural fluid, and the thoracoscopic results. The most remarkable findings were the non-odorous, cloudy, greenish sterile exudate with extremely low glucose concentration and a high LDH concentration, and the parietal pleura which appeared granulated on thoracoscopy.