In this report we describe the clinical presentation, diagnosis, treatment and outcome of a 45-year-old woman with thoracic endometriosis. Four clinical presentations have been described. The majority have presented with catamenial pneumothorax, followed by hemothorax, hemoptysis and lung nodules. Our patient presented with right-sided hemothorax and lung nodules. Video-assisted thoracoscopic aurgery confirmed the presence of endometrial tissue embedded in the diaphragmatic pleura. Talc pleurodesis alongwith atotal abdominal hysterectomy and bilateral salpingo-oophorectomy led to a clinical and radiological resolution.