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Congenital lymphatic dysfunction pathophysiology remains incompletely understood, largely because of the lack of reliable diagnostic tests. Recently, dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) has emerged as a technique for visualising lymphatic anatomy.1 However, intranodal needle placement is technically challenging in neonates, limiting its clinical applicability. To address these challenges, non-contrast heavy T2-weighted magnetic resonance lymphangiography (MRL), an application of MRI, has been used, because it highlights water-rich structures.2 Importantly, DCMRL elucidated two aetiologies: pulmonary lymphatic perfusion syndrome (PLPS) and central lymphatic flow disorder (CLFD). PLPS is characterised by abnormal lymphatic perfusion from the thoracic duct (TD) to the pulmonary system, while CLFD involves an abnormal or absent TD with global lymphatic dysfunction.3 This distinction is clinically relevant for treatment planning and prognostic assessment. Despite these advances, few studies have reported the usefulness of MRL for neonatal chylothorax. Addressing this gap, we report the MRL imaging in a neonate with chylothorax consistent with PLPS. This study was approved by the Ethics Committee of Fukuoka Children’s Hospital (permission number: 2022–58).