Gemcitabine is indicated for the treatment of nonmicrocytic lung, breast, pancreatic, bladder and ovarian cancer. Mild dyspnea has been reported but the incidence of severe lung damage is low. We report the case of a 58-year-old woman diagnosed with locally advanced infiltrating ductal carcinoma of the breast who received gemcitabine as part of neoadjuvant chemotherapy and suffered from severe pulmonary toxicity. We reviewed the cases published in the literature and conclude that although Gemcitabine is generally well tolerated, pulmonary toxicity requires high level of suspicion and prompt treatment to prevent an unfavourable outcome.