A single, intravenous administration of a low dose of monocrotaline pyrrole (MCTP), a derivative of the pyrrolizidine alkaloid monocrotaline (MCT), induces progressive pulmonary hypertension and right ventricular hypertrophy (RVH) in rats. The temporal relationship between morphologic alterations, biochemical markers of lung injury, and the development of pulmonary hypertension was determined during the developing pulmonary disease. Three days after a single iv injection of 3.5 mg/kg MCTP, small increases in bronchoalveolar lavage (BAL) fluid lactate dehydrogenase (LDH) activity and accumulation in the lungs of intravenously administered 125I-bovine serum albumin (BSA) were associated with minimal to mild interstitial edema around large airways and blood vessels. By Day 5, BAL fluid LDH activity and 125I-BSA accumulation had increased further, and lung weight/body weight ratio and BAL fluid protein concentration were greater than those of control. Interstitial edema was more pronounced and involved patches of alveolar septal walls. A mild increase in numbers of mononuclear cells, including hypertrophied interstitial cells, was evident in these areas. Walls of pulmonary arteries less than 60 microns in diameter were mildly thickened. By Day 8, scattered clusters of alveolar sacs contained serous exudate, and interstitial mononuclear infiltrates were more pronounced. Mild to moderate thickening of arterial walls was apparent in small and large vessels. By Day 14, pulmonary arterial pressure was elevated and RVH was evident. Arterial walls were thickened and had hypertrophy of medial smooth muscle cells and intercellular edema, which was particularly prominent in areas with perivascular interstitial inflammation. Large patches of lung interstitium and alveolar lumens contained serous or fibrinous exudate. In summary, a single, intravenous administration of MCTP induced a delayed and progressive pulmonary microvascular leak, interstitial inflammation, and alterations in muscular blood vessels which resulted in pulmonary hypertension within 14 days. These morphologic, biochemical, and hemodynamic changes are nearly identical to alterations induced by the parent alkaloid, MCT.