A 15-year-old girl with end-stage lung disease from cystic fibrosis underwent a bilateral lung transplantation. Infarction of the left lung allograft required its removal on day 10. The patient went on to have an uneventful recovery except for a prolonged air leak from the right allograft of approximately 29 days. The left pleural cavity opacified with time with no clinical or radiologic evidence of empyema. The patient was discharged on day 35 in good condition. On a follow-up examination 6 months after transplantation, she appeared to be functioning extremely well with a single lung allograft. This case report challenges the conventional wisdom that bilateral pneumonectomy and single lung transplantation are not an option to be considered for patients with cystic fibrosis or bronchiectasis.