A patient with a paraneoplastic effusion presented with respiratory distress one hour after a 2 500 ml pleural aspiration performed at noon. A chest X-ray shows signs of unilateral pulmonary oedema. Re-expansion pulmonary oedema is a rare complication. Oxygen therapy is usually sufficient. It is advisable not to perform this procedure outside normal hours and to withdraw a maximum of 1 500 ml at a time.