A 41-year-old man with a renal transplant was admitted with cough, fever, and dyspnea. Although chest radiography was normal, high-resolution CT demonstrated small hazy round opacities in the centrilobular regions throughout both lungs. The biopsy specimen revealed metastatic calcification in the alveolar septa and the walls of the bronchioles and arterioles. High-resolution CT may be useful for the early detection of metastatic pulmonary calcification when plain radiography is negative and therapy has the potential to reverse the process.