Parahilar alveolar consolidation is a known radiologic pattern found in cardiogenic pulmonary edema. We present a patient with mitral insufficiency with usual clinical findings but unusual radiologic pattern. The radiographic examination showed cardiomegaly with airspace consolidation predominantly in the right upper lobe. The clinical and radiologic picture recovered after treatment with diuretics. We conclude that localized pulmonary edema secondary to mitral insufficiency should be suspected in the presence of any type of airspace consolidation predominantly in the right upper lobe.