Many patients take beta-blockers to control hypertension or angina, and such medication is often continued for years. Drug-induced pulmonary diseases due to beta-blockers have been published previously as pulmonary parenchymal infiltration and pleurisy, but bilateral multifocal and extensive pleural thickening alone has not been mentioned previously. In our case, Naranjo Adverse Drug Reaction probability scale score indicated that massive pleural thickening was a possible adverse reaction associated with long term use of acebutolol.