Pulmonary‑renal syndrome (PRS) is a combination of diffuse alveolar hemorrhage and glomerulonephritis. Its etiology is diverse but the majority of cases are related to ANCA‑associated vasculitis. The most characteristic symptoms are hemoptysis and rapidly progressing glomerulonephritis. Treatment consists in induction of remission by application of cyclophosphamide, corticosteroids and, in particular cases, carrying out plasmapheresis. The paper presents a case of a 55‑year‑old female with massive alveolar hemorrhage and acute renal failure. The patient underwent initial treatment with– cyclophosphamide, according to the CYCLOPS trial, corticosteroids and plasmapheresis. This case proves that the PRS may be a life‑threatening systemic disease. Its treatment must be individualized and require considerable experience from the attending physician.