The development of adult respiratory distress syndrome (ARDS) can be associated with a variety of clinical disorders. Pulmonary cryptococcosis occurring in immunocompromised patients has been reported with increasing frequency because of the rapidly rising number of immunocompromised hosts and the improvement in diagnostic techniques. But pulmonary cryptococcosis causing ARDS in immunocompetent patients has not, to present knowledge, been described. Here a rare case of pulmonary cryptococcosis is reported in an immunocompetent host who developed adult respiratory distress syndrome. The clinical course, radiologic patterns, methods of diagnosis and treatment are reviewed.