Pleural effusion is rarely noted in pulmonary cryptococcosis. Although cryptococcosis is mostly associated with HIV infection, in developed countries, it mostly occurrsin immunosuppressed non-HIV-infected individuals. Herewe present the first case of pulmonary cryptococcosis manifesting as pleural effusion in a woman with breast cancer. A 30-year-old woman (G1P0A0) who was 7 months pregnant visited the hospital because of decreasing fetal movements 2 days prior to admission; she was diagnosed with Shealsointrauterine fetal death, had dyspneasince a week and pain in the bones since 3 months prior to admission. She had a wound that resulted from a lump in the right breast, and it was diagnosed via biopsy as ductal invasive carcinoma. Bilateral pleural effusion was noted. On pleural fluid examination, Cryptococcusneoformans was detected. Thus, she received 200 mg fluconazole twice a day. Her condition improved, and she had no complaint of dyspnea. Chest radiographs obtainedafter fluconazole treatment showed that her pleural effusion decreased; thus, we were unable to perform thoracocentesisfor the culture. She was prepared for chemotherapy. Cryptococcosis has been described as an opportunistic infection that predominantly affects immunocompromized patients. The pregnant woman included in our study was diagnosed with ductal invasive carcinoma. Pregnancy and cancer might have predisposed her to Cryptococcus infection owing to immunosuppression. The optimal duration of treatment for cryptococcosis in patients with cancer remains controversial. However, it has been indicated that long-term treatment is unnecessary because there is no relapse of the infection.. Cryptococcosis rarely occurs in immunocompetent patients, and it usually does not involve any manifestations. Our patient had dyspnea and bilateral pleural effusion. Serological testing is required when cryptococcosis is suspected. Future studies are recommended to improve the treatment of cryptococcosis in pleural fluid and increasing the cure rate of cryptococcosis. © 2020 Nova Science Publishers, Inc..