Management of persistent air leak (PAL) is a challenging task. We report a case involving a 2-year-old female patient who presented with complicated necrotizing pneumonia, lung abscess, empyema, and pneumatocele. Extracorporeal membrane oxygenation was initiated because of refractory cardiopulmonary failure. The patient underwent thoracic surgery with lobectomy and decortication for her underlying pulmonary problems. PAL was noted after the thoracic surgery. The patient received autologous blood patch pleurodesis (ABPP), and the air leak resolved after three instillations. ABPP may be the optimal choice for the management of PAL in pediatric patients.