Noncardiogenic pulmonary edema occurs in 35% of salicylate-intoxicated patients who are over 30 years old. Cigarette smoking, chronic salicylate ingestion, a component of metabolic acidosis, and the presence of neurological symptoms on admission are strong risk factors for the subsequent development of pulmonary edema in the appropriate age group. In the absence of these risk factors, salicylate-induced pulmonary edema is rare. The etiology is multifactorial, but it centers around altered vascular permeability in the lungs.