Chylothorax is a rare complication of central venous catheterization. Massive chylothorax could result in respiratory failure and unstable hemodynamic status, causing high mortality. The classic appearance of chyle is milky white, but it could also show other appearances. Central venous catheterization is a common procedure in intensive care units and in patients with end-stage renal disease for undergoing hemodialysis. We report a case of a new diagnosis of microscopic polyangiitis complicated with rapidly progressive glomerulonephritis. Tension chylothorax developed after the placement of permanent catheter. After pigtail drainage of pleural effusion and supportive care, patient was stabilized. Her chylothorax had completely resolved.