A 51-year-old man underwent left upper lobectomy due to pulmonary adenocarcinoma (cT2N1M0, stage IIB) in August, 2003. Since he turned out pT2N3M0 stage IIIB, he received combination chemotherapy with carboplatin and gemcitabine. During a second course chemotherapy, he was admitted again because of dyspnea and the deterioration of diffuse interstitial shadows in both lungs. He was treated with various antibiotics and corticosteroids. Unfortunately, he could not recover. An autopsy was performed. Microscopic features of the lung revealed diffuse alveolar damage and pulmonary hemorrhage. In this case, pulmonary hemorrhage should be considered as a complication of gemcitabine-induced lung injury.