Abstract Chylothorax is an uncommon occurrence seen most frequently in patients with malignancy. We report a case of chylothorax following fracture-dislocation of the thoracolumbar spine, the ninth reported case in the English literature. Seven cases of chylothorax were identified in a 12-year period at our institution. A total 925 patients sustained fractures of the thoracic or lumbar spine during this period, and this was the only case associated with chylothorax. We have reviewed the literature, and recommend conservative management utilizing closed thoracotomy drainage and total parenteral nutrition for at least 2 weeks. If chyle flow has not diminished by that time then thoracic duct ligation should be considered.