Primary pleural sarcomas constitute <1% of all primary lung cancers. Synovial sarcomas of the pleura are extremely rare. They may be mistaken for malignant mesothelioma or other spindle cell tumors, but the confirmation is by histology and immunohistochemistry. Synovial sarcomas are aggressive with a high incidence of recurrence. In this case report, we present the 18-fluoride-fluoro deoxyglucose (FDG) positron emission tomography-computerized tomography (PET-CT) findings of patient with primary pleural synovial cell sarcoma. The pretreatment and postchemotherapy FDG PET-CT scans are presented. The role of FDG PET-CT in initial staging and response assessment in this interesting case of pleural synovial sarcoma is presented.