Acute, noninfectious, eosinophilic pneumonia with respiratory failure has been described in adults. This new form of eosinophilic lung disease differs from the previously described types of eosinophilic pneumonia. Patients with this entity develop rapid progressive respiratory failure, which seems to respond to corticosteroid therapy. Eosinophilia in lung biopsy specimen, or in bronchoalveolar lavage fluid seems to be a common denominator. We present the first pediatric case of this new, distinct form of eosinophilic lung disease and review the pertinent literature.