HELLP syndrome is one of the life-threatening situations in pregnancy and has a tendency to multi organ insufficiency in some particular cases. We discuss about a 14 years old woman with molar pregnancy who complicated by the syndrome in 16 weeks of gestation ,24 hours after evacuation of conception products. She was one of the missed molar pregnancies with management delays. After 24 hours of her evacuation, the patient developed sever plural effusion and returned to a normal condition after7 days.it was an exceptional situation implies a high risk of mortality. Based on our knowledge, there are very rare reports as such HELLP syndrome complicates complete molar pregnancy in 16 weeks of gestation. Notably we will report massive plural effusion caused by the syndrome in molar pregnancy as a very scare manifestation of HELLP syndrome. Early diagnosis of molar pregnancies is very important. When HELLP syndrome complicated molar pregnancy, treatment is similar to non- trophoblastic pregnancy with only Conservative closed management. Respiratory distress due to sudden onset massive pleural effusion is not as a common symptom of HELLP syndrome but our assertion is, it’s possible and only conservative management may be sufficient for this situation too.