The small number of patients suffering from pulmonary involvement with Sporothrix schenckii has prevented prospective controlled studies that could determine the optimal therapy for this chronic infection. The clinician's ability to determine the best medical treatment for chronic cavitary pulmonary sporotrichosis is also tempered by the limited use of newer azole antifungal agents in this disorder as well as the relative lack of efficacy reported with older therapies. We present a 50-year-old male with primary pulmonary sporotrichosis whose chronic cavitary disease responded to oral itraconazole.