Empyema necessitatis is a rare complication of empyema characterized by a spontaneous extension of pus from the pleural space into adjacent soft tissues. It is uncommon in the pediatric population and is usually caused by Mycobacterium tuberculosis. This report describes the youngest reported case of empyema necessitatis. The clinical examination and CT scan are diagnostic. The causative organism was methicillin-resistant Staphylococcus aureus, which has not been previously reported. Treatment involves drainage of the abscess and appropriate antimicrobial therapy.