A small number of cases of cigarette-smoking-associated respiratory bronchiolitis (RB) with positive findings on the chest radiograph have been reported in the literature. High-resolution computed tomography (HRCT) findings are available in even fewer cases. We describe the case of an asymptomatic female smoker presenting with a reticulomicronodular infiltrate on a routine chest radiograph. High-resolution CT was characterized by ground-glass opacities and centrilobular micronodules with an upper lobe predominance. Surgical biopsy revealed peribronchiolar lesions, with accumulation of brown pigmented macrophages in the lumen of alveolar and bronchiolar lumen, consistent with the pathologic diagnosis of RB.