Introduction: Central venous catheterization is usually used for monitoring the cardiovascular state and administrating for fluids, total parenteral nutrition(TPN) and drugs. Extravasation of TPN by central venous catheter (CVC) is rare but fatal. CASE: A 70-year-old female underwent craniotomy and clipping in right posterior communicating artery for incidental aneurysmal formation. She was inserted a left subclavian CVC for surgery. After then she received fluid and antibiotics via subclavian CVC. In Post-operative day(- POD) 7, she had shortness of breath and had hypoxia with low blood pressure. Oxygen was supplied with nasal cannular and her blood pressure was recovered with inotropics. Chest radiography showed a large left-sided pleural effusion (Figure 1-1) and migrations of the CVC. A pigtail catheter was inserted immediately for effusion drainage. Pleural fluid analysis revealed a milky and triglyceride concentration was 465 mg/ dl and glucose was 207 mg/dl, the serum glucose was 98 mg/dl. A pleural fluid to serum glucose ratio >1 showed extravasation of TPN into her pleural space, which is not typical for chylothorax. Comparing the chest radiography POD1 with that of POD7, the migration of the CVC tip was seen (Figure 1-2). TPN was discontinued and the CVC was removed. Her symptoms and medical conditions were improved. After removing pigtail catheter at POD 13, there was no recurrence of pleural effusions and complications. Conclusion: We should have careful attention to the position of the CVC by radiography and be aware of this. These could be taken proper management immediately and reduced complication.