Pulmonary torsion is an uncommon event and may occur spontaneously or after trauma or surgery. It may involve the entire lung or individual lobes. Early recognition with prompt intervention is required to prevent hemorrhagic infarction or gangrene and salvage parenchyma. Surgical options of detorsion or resection are dependent upon tissue viability. A case of spontaneous torsion of the entire right lung is presented that reflects the first successful nonresectional management of this entity to be reported. Guidelines for appropriate management are discussed based on an understanding of the etiology, pathophysiology, and natural history.