Pulmonary haemorrhage in children is rare and may be either focal or diffuse, idiopathic or associated with an underlying disease. Focal bleeding is usually associated with congenital anomalies or localized acquired disease. Many of the disorders causing diffuse alveolar haemorrhage appear to be immunologically mediated. Treatment modalities include management of the underlying disease and the use of corticosteroids, chloroquine and/or cytotoxic drugs and induce remission in more than half of the patients with diffuse haemorrhage.