The standard therapy for patients affected by acute promyelocytic leukemia is based on all-trans-retinoic acid (ATRA), whose rare complication is a syndrome known as retinoic acid syndrome. We describe for the first time the computed tomography findings of a case of ATRA syndrome with typical pulmonary findings, along with the involvement of the upper abdomen organs (liver and spleen) as a further complication of the pathology.