We report the case of a man with intense cough for several months and a few days of severe dyspnea. A massive pleural empyema due to Actinomyces meyeri was diagnosed by radiological, microbiological and thoracoscopic means. Pleural infections caused by this anaerobic bacterium are very rare and should be considered when risk factors like male gender, chronic alcohol abuse, and poor oral hygiene are present. Penicillin-based antibiotic treatment and surgical decortication led to recovery.