Objective: To investigate the diagnosis and treatment of bilateral chylothorax following neck dissection for thyroid cancer. Methods: The clinical data of two patients with bilateral chylothorax after neck dissection for thyroid cancer were retrospectively analyzed, and combined with related literature review. Results: Both patients underwent neck dissection for papillary thyroid carcinoma and no lymphorrhea was observed in either of them during operation. On the fourth postoperative day, both patients developed shortness of breath and dyspnea, and were found to have bilateral hydrothorax by chest X-ray examination and milky chylous fluid was drained with bilateral closed drainage of pleural cavity, and then were diagnosed as bilateral chylothorax. After aggressive treatment such as fasting and octreotide administration, the drainage volumes of the two patients were gradually reduced, and their drainage tubes were removed after thoracic fluid collections disappeared in review X-ray examination. Conclusion: Bilateral chylothorax is an extremely rare complication after neck dissection for thyroid cancer, and aggressive conservative treatment is safe and effective after early detection.