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Congenital abnormalities or post-operative damage of the lymphatic system are rare causes of neonatal chylothorax or chylous ascites. Lymphangiography is a valuable tool for the diagnosis and treatment of lymphatic leaks and the assessment of congenital lymphatic abnormalities. We present two cases where lymphangiography was used to assist in thoracic duct embolization and surgical ligation. A review of the literature regarding the use of lymphangiography in neonates was also performed.