Chylothorax has been reported rarely in patients with anterior release of severe adolescent idiopathic scoliosis (AIS) using video-assisted thoracoscopic surgery (VATS). A young girl was diagnosed with chylothorax after anterior release of the spinal deformity. After medical treatment, massive chyle leakage was still noted, and 2 surgical interventions were performed to treat the complicated condition. Anatomic variation of the thoracic duct as a network was highly suspected, and tissue glue was applied for adhesion. We present this case with a discussion of treatment for complicated chylothorax after VATS correction of severe AIS.