Noncardiac pulmonary edema can occur not only after cardiac surgery with cardiopulmonary bypass but also after noncardiac operations. This so-called transfusion-related acute lung injury (TRALI) has been attributed to the transfusion of homologous blood and plasma. In the presence of normal left ventricular function an acute increase in pulmonary capillary permeability leads to massive protein-rich pulmonary edema, reduced pulmonary function, and intravascular hypovolemia. This may be caused by leukocyte antibodies. Signs and diagnostic and therapeutic procedures are discussed with reference to a case report.