Pseudocyst is a common complication of both acute __ampersandsignamp; chronic pancreatitis due to any cause. It is a localised fluid collection, rich in pancreatic enzymes surrounded by a wall of non- epithelialized fibrous tissue. Mostly it presents in and around the pancreatic tissue but on rare occasions it may extend into mediastinum causing symptoms due to compression __ampersandsignamp; invasion of adjacent structures. We report a rare presentation of a young patient with dysphagia due to pancreatic pseudocyst extending into posterior mediastinum and compressing esophagus. Approximately 50 cases of mediastinal extension of the pancreatic pseudocyst in the world literature are reported. Successful drainage of a mediastinal pseudocyst using a transesophageal approach under endoscopic ultrasound guidance has been reported. The literature was reviewed for clinical presentation, complications, and available treatment options for mediastinal pancreatic pseudocysts.