A patient is described who developed respiratory distress or a ‘stiff-lung syndrome’ following lymphangiography. There was no evidence of pre-existing lung disease. Excessive accumulation of the oily medium with liberation of fatty acids in the lung probably was the result of an early operative manipulation of the retroperitoneal lymphatic system. Follow-up lung function studies showed a persistent impairment of diffusing capacity. Pulmonary complications of lymphangiography are briefly revi