Re-expansion pulmonary oedema is an uncommon and potentially life-threatening complication after rapid expansion of a collapsed lung. Symptom onset (cough, chest pain, dyspnoea) is often sudden and the clinical picture may be dramatic. Pathogenesis is complex and partially unclear. A well-timed intensive therapy allows a better prognosis. To date, only one case of re-expansion pulmonary oedema following fenestration of a giant hepatic cyst has been reported in the literature. We here report a new case after surgical fenestration of a giant hepatic cyst.