Anti-glomerular basement membrane disease (anti-GBM) is a well-documented, small vessel vasculitis that is classically associated with glomerulonephritis and alveolitis [ 1 ]. However, regardless of clinical process, not every patient will present with a constellation of classically associated symptoms. Literature review demonstrates that early anti-GBM disease can present as glomerulonephritis without alveolitis [ 2 , 3 ]. In this case report, we describe the unique clinical course of a 26-year-old male who originally presented with hemoptysis and his subsequent clinical workup revealing anti-glomerular basement membrane disease without renal involvement.