This is a case report of 32 years old male, who presented in outdoor clinic of Pulmonology Department, Jinnah Hospital, Lahore, with progressively increasing shortness of breath over 2 years, multiple episodes of dry cough over 9 months, history of low-grade fever for 15 days and haemoptysis for the last one day. He was diagnosed as a case of miliary tuberculosis on the basis of his chest X-ray findings and was on anti-tuberculosis treatment by the GP of the locality. Diagnosis of pulmonary alveolar microlithiasis was made on the basis of clinical features and laboratory findings.