Although Legionella infections have been widely reported, the clinical importance of Legionella lung abscess has not been sufficiently emphasised. A renal transplant recipient with a pulmonary abscess due to Legionella pneumophila is presented and 21 other cases from the literature are reviewed. Seven abscesses arose in renal transplant patients. Even though an abscess may develop during treatment, superimposed infection with other micro-organisms appears to be uncommon, and an abscess may be expected to resolve with prolonged appropriate antimicrobial therapy alone. Recognition of lung abscess as a complication of legionella infection will therefore prevent unnecessary operations.