Catamenial pneumothorax (CP) is considered to be the most common form of thoracic endometriosis syndrome, which also includes catamenial hemothorax, catamenial hemopneumothorax, catamenial hemoptysis, and endometriosis lung nodules. Diagnosis can be hinted by high recurrence rates of lung collapse in a woman of reproductive age with endometriosis. In our case we present a 41 year old woman at the time of the second incidence with a left pneumothorax and holes in the pericardium in the diaphragm location. Laparoscopic evaluation was performed along with video-assisted thoracoscopy and treatment was performed with both techniques.