Clopidogrel is a platelet aggregation inhibitor that increases the risk of bleeding complications when combined with acetylsalicylic acid. We report a rare case of a 79-year-old male treated with clopidogrel and acetylsalicylic acid after coronary angioplasty and stenting to treat unstable angina. Two months after initiation of therapy, the patient presented with symptomatic bilateral pleural effusion. Examination of both effusions confirmed the diagnosis of spontaneous bilateral hemothorax due to combined anti-platelet therapy. Serious functional sequelae were still present 18 months after diagnosis despite bilateral pleural drainage and respiratory physiotherapy.