Lacticaseibacillus rhamnosus (L. rhamnosus), known for its beneficial effects on gut and vaginal microflora, is considered a low-pathogenicity organism with the propensity to cause infection in immunocompromised patients. To our knowledge, no cases have been reported in liver transplant recipients (LTR). Here, we report the first case with L. rhamnosus intra-abdominal infection and pleural empyema in a LTR, along with review of the literature. The isolate found in peritoneal and pleural fluid cultures exhibited complete resistance to routinely prescribed antibiotics in LTR. The majority of infections documented in the literature occur in individuals with chronic health conditions, and are linked to high mortality rates. In conclusion, while L. rhamnosus is an opportunistic pathogen, this and previous documented examples underscore the need of heightened recognition of its potential as a pathogen, and its resistance in immunocompromised patients. In order to get a more favourable result, it is crucial to initiate tailored early antimicrobial therapy alongside efficient source control.