Neurogenic pulmonary edema is a potential complication of severe central nervous system insult. In the patient described, neurogenic pulmonary edema resulted from gunshot injuries to the head. Aggressive supportive care and intravenous administration of dopamine successfully resolved this pulmonary complication. Although such treatment is crucial in patients with possibly reversible central nervous system injury, the patient described had irreversible brain injury. The authors discuss current theories of the pathogenesis as well as diagnosis and treatment options.