We describe the first reported case (to our knowledge) of pulmonary granulomatosis caused by aspirated green tea. In this case, we found granulomatous alveolitis with lymph follicles, T lymphocytosis with predominantly CD8+ cells in the bronchoalveolar lavage fluids, positive serum precipitin and proliferative response of peripheral blood lymphocytes to the tea infusion, and efficacy of steroid therapy. These results indicate that the pathogenesis of the disease was due to both humoral and cellular immunities to the aspirated green tea.