INTRODUCTION: Salmonellae are gram negative rods belongs to Enterobacteriaceae. They commonly cause enterocolitis, enteric fever, endovascular infection and bacteremia with localized infection which can occur at any site. Pulmonary involvement especially empyema is very rare and usually reported in immunosuppressed patients secondary to co-morbidities such as HIV,malignancy,diabetes and iatrogenic (steroids/chemotherapy). CASE DESCRIPTION/METHODS: 76-year-old male with past medical history of Ischemic cardiomyopathy with 35% EF status post AICD, CKD stage 3, dementia and stroke presented to ER for generalized weakness, fever, coughing, right sided lower chest pain, abdominal pain, non-bloody watery diarrhea and vomiting for 3 days. Physical examination revealed new oxygen requirement with respiratory rate 24/min, blood pressure 110/75 mmgh, heart rate 70/min and temperature 100.9 F. He was ill appearing, lethargic with +1 pedal edema. Abdomen was soft but with epigastric/right upper quadrant tenderness. Decreased breath sounds were present at bases. Initial laboratory results showed leukocytosis of 12000 K/ul, normal AST/ALT, elevated bilirubin 2.1 mg/dl, Alkaline phosphatase 324 u/l, BUN 37 mg/dl and Creatinine of 1.8 (at baseline). Chest x-ray showed right greater than left small bilateral pleural effusions and bibasilar atelectasis/infiltrates. Ultrasound RUQ negative for acute cholecystitis. Patient was started on intravenous lasix was started given concern for volume overload and IV antibiotics for possible aspiration pneumonia. Low grade fevers persisted for next 24-36 hrs along with worsening breathing. Repeat chest x-ray showed worsening right pleural effusion. CT chest revealed large loculated left pleural effusion with infiltrates, small right effusion with nearby atelectasis and distended esophagus. Chest tube was placed along with injecting tPA/DNase to help break up loculations. Patient passed swallow evaluation and further testing was negative like blood/sputum cultures and stool studies. Pleural fluid was exudative and grew few non-typhoid salmonella species without reporting of exact identification by laboratory. Patient was discharged in stable condition on 4 weeks of Amoxicillin/clavulanic acid after consultation with Infectious disease specialist. DISCUSSION: Non-typhi salmonella causing pneumonia and empyema is very rare. Most common presentation is gastroenteritis. Patients presenting with gastroenteritis and pulmonary involvement, clinicians should keep salmonella as a differential diagnosis.