A 44-year-old patient presented with pulmonary sarcoidosis with pleural involvement, which is rare because the pleura is rarely affected. The patient had a dry cough and shortness of breath lasting 4 weeks. Computed tomography of the chest revealed pulmonary nodules, subpleural nodules, mediastinal lymphadenopathy, and bilateral pleural effusion. Thoracoscopic pleural biopsy confirmed non-caseous granulomas, demonstrating pleural involvement due to sarcoidosis. The patient received treatment with corticosteroids, after which all unpleasant symptoms gradually disappeared. A follow-up CT 8 weeks later showed complete disappearance of the pleural effusion. This case report emphasizes that in pleural effusion and pleural nodules, other causes must be excluded and sarcoidosis must be considered as the underlying disease.