Smoking-related illnesses contribute to a large number of deaths in the industrialized world and their treatment comprises a substantial percentage of total healthcare dollars. The most common and most well-known smoking-related illnesses include chronic obstructive pulmonary disease, bronchogenic carcinoma, and ischemic heart disease. However, the role of cigarette smoking in the pathogenesis of other lung diseases is becoming increasingly apparent. Knowledge of both the histologic and radiographic manifestations of smoking-related lung disease is important to the radiologist as imaging findings can be nonspecific. Finally, correlation of imaging and clinical information may obviate the need for open lung biopsy.