This report describes the clinical course of a patient who developed obliterative bronchiolitis after viral infection on three separate occasions. Long-term follow-up is given. It is suggested that the syndrome of late pulmonary deterioration after transplantation may be steroid responsive if treatment is initiated early in the natural history of the syndrome. In addition, it is suggested that increased emphasis should be placed on the documentation of viral infection in transplant recipients to define a possible interaction between infection and rejection.