Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of alveolar hemorrhage, characterized by recurrent episodes of alveolar hemorrhage, hemoptysis and secondary iron-deficiency anemia which occurs primarily in childhood. The pathogenesis is not known. A diagnosis of IPH can be made only when other causes of diffuse alveolar hemorrhage have been reliably excluded. A 15 year-old boy with recurrent cough, bloody sputum, dyspnea and chronic fatigue was hospitalized. Chest radiograph demonstrated bilateral alveolar infiltrates. HRCT revealed areas of ground glass opacities. Transbronchial lung biopsies showed alveolar hemosiderosis and the bronchoalveolar lavage fluid was rich in hemosiderin-laden macrophages. Serologic markers; ANA, anti-ds-DNA, RF, c-ANCA, p-ANCA, and anti-BM were negative. No evidence of other organ involvement was found. The patient was diagnosed as IPH and corticosteroid therapy was started. (Tur Toraks Der 2008;9:124-6)