Background: Pancreaticopleural fistula (PPF) is a rare complication of pancreatitis resulting from pancreatic duct disruption, leading to recurrent and often massive pleural effusions.

Case Presentation: We report three cases of pancreaticopleural fistula presenting with variable clinical and radiological features. Patients presented predominantly with respiratory symptoms and minimal abdominal complaints. Detailed imaging using contrast-enhanced computed tomography (CECT) demonstrated pancreatic ductal dilatation, parenchymal calcifications, necrotic collections, and well-defined fistulous tracts extending from the pancreas into the pleural cavity. Pleural fluid analysis confirmed elevated amylase levels.