Pulmonary alveolar microlithiasis (PAM) is a rare disease of unknown aetiology. It is characterized by the presence of calcific concretions (calcospherites) inside the alveoli. We present a case of a 22 year old sickle cell anaemia patient with an incidental finding of PAM. This report is to highlight the fact that though rare, PAM is not entirely unheard of in this environment and should be kept in mind as a cause of diffuse opacities of the lungs.