The sequential changes of paraquat-induced pulmonary damage were studied using high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) in long-term follow-up. Among the cohort of 27 patients who had ingested paraquat, the HRCT findings showed a normal (n = 14) and an abnormal group (n = 13). Increased paraquat ingestion in the abnormal group was associated with more rapid and severe pulmonary changes. Ground-glass opacity on HRCT peaked on day 7 after ingestion. Between 2 weeks and 1 month, consolidation increased and pulmonary fibrosis progressed, and slow improvements were observed for up to six months. Compared with the PFT results obtained at 1 and 6.5 months, FVC, FEV1, and diffusing capacity all improved slightly. Lung changes after paraquat intoxication are functionally and radiologically reversible following treatment.