A 37-year-old man was admitted to our hospital complaining of dry cough and dyspnea. His chest radiographs showed severe bullous changes in the upper lobes and scattered small nodules in the lower. During the course of further examination, a spontaneous left pneumothorax developed in the lung, and video-assisted thoracic surgery was performed to remove a bulla. Multiple noncaseous granulomas were seen and sarcoidosis was diagnosed. Here we report a case of pathologically investigated bullous sarcoidosis, which is rarely seen to generate bullae due to granulomatous lesions. Therefore, it is important to consider sarcoidosis in making a differential diagnosis when a diffuse lung disease with cystic change is encountered.