Chylothorax is a rare but serious complication that presents after thoracoabdominal aortic aneurysm surgery. There are insufficient data to reach a consensus on how to manage it. Some researchers have suggested early reoperation for high output drainage. We present the case of a patient who underwent thoracoabdominal aortic replacement and who subsequently developed postoperative chylothorax. High output (> 1,000 mL per day) chest tube drainage until postoperative day 4 drastically decreased and stopped in a week with the administration of somatostatin and total parenteral nutrition which helped avoid a major re-exploration. Surgery should be reserved as an option only for patients with persistent leaks that do not respond to somatostatin therapy.