We present the cases of two adult patients hospitalized due to alveolar hemorrhage. In the absence of data regarding the affection of other organs and after a follow-up of 20 months and 4 years respectively, they were diagnosed as idiopathic pulmonary hemosiderosis (IPH). These patients represent two opposed extremes in the clinical spectrum of the disease, yet none of them needed therapy once they overcame the acute episode, remaining asymptomatic. Although the usual clinical course of IPH involves a short survival, given the evolution of our cases and of others previously described in the literature, one may think that at least a subgroup of adult patients have just one alveolar hemorrhagic episode as the result of the exposition to an unknown inhaled stimulus.