Acute exposure to high concentrations of cadmium fumes may cause acute chemical pneumonitis with a possibly fatal outcome. The etiologic diagnosis of acute cadmium intoxication from inhaled fumes may be difficult and can be confused with other forms of acute respiratory failure. We report on a case of a fit 53 year-old man who was exposed to cadmium fumes after flame-cutting an alloy containing around 10% of cadmium for a period of 60-75 minutes. He developed severe chemical pneumonitis and died 19 days after exposure.