Objective:To describe an unusual case of acute eosinophilic pneumonia (AEP) associated with hemodynamic instability.Design:Case report, clinical.Settings:Tertiary care intensive care unit (ICU).Patient:A single patient admitted to the ICU.Interventions:Intravenous corticosteroids.Measurements and Main Results:Resolution of distributive shock and respiratory failure.Conclusions:AEP with respiratory failure was first reported in 1989 as a distinct clinical entity. Patients with this variant of eosinophilic lung disease develop acute hypoxemic respiratory failure with a rapid response to treatment with corticosteroids. The characteristic feature of this syndrome is a predominance of eosinophils found in bronchoalveolar lavage fluid and lung biopsy. Despite the increasing number of reported cases, to our knowledge, distributive shock has not been reported as a feature of AEP. We report a unique case of AEP associated with shock and review the pertinent literature.