Metastatic pulmonary calcification occurs in association with several disease processes and has a highly variable prognosis. In certain patients, it may prove fatal, and therefore prompt recognition of radiological signs is helpful for optimising patient management. We describe the progressive changes seen on CT in a 59-year-old man who had undergone renal transplant and subsequently developed metastatic pulmonary calcification. The merits of the different imaging techniques available and possible treatment options are reviewed.