Herein we report the cause of a 46-year-old woman who presented with recurrent right pneumothorax following hysterectomy with right salpingo-oophorectomy for pelvic endometriosis. Video-assisted thoracoscopy revealed endometrial implants in the posterior parietal pleura and the middle lobe. Ruptured apical blebs were also present. The middle lobe lesions and the apical blebs were resected. A partial pleurectomy was carried out to remove the endometrial foci in the parietal pleura; the remaining pleural surface was mechanically abraded. The favorable outcome was confirmed at 2-year follow-up.