A case of a 58 years old male, ex-smoker since 10 years (30 pack/years), who was admitted to our hospital due to bilateral pulmonary nodules is presented. Abdominal CT was normal and bronchoscopy showed endobronchial alterations of mild inflammation. A nodule was removed by open lung biopsy. Histological diagnosis excluded cancer and confirmed Cryptogenic Organizing Pneumonia - Bronchiolitis Obliterans with Organizing Pneumonia (COP – BOOP). This di¬sorder is characterized by granulomatous tissue that obstructs small bronchioles and organizes pneumonia. Open lung biopsy or VATS is required to establish the diagnosis with certainty. In BOOP, bilateral pulmonary nodules as the only manifestation in chest radiograph are rare. Pneumon 2004, 17(2):207-212.