Amiodarone is an effective antiarrhytmic drug and it is used to treat supraventricular or ventricular rhythm disturbances. Nevertheless it is not free from side effects. Acute amiodarone-induced pulmonary toxicity is one of them. We referred a 55-year-old man who started on amiodarone after a mitral valva replacement. Afterwards he had acute respiratory failure and diffuse ill-defined opacities. The diagnosis was confirmed by detection of lots of foamy macrophages in the bronchoalveolar lavage fluid. Relief of symptoms and arterial blood gases improvement was achieved when he started on corticosteroids and amiodarone treatment was stopped.