Tumor necrosis factor inhibitors have been implicated in many pulmonary complications. Before starting these class of drugs latent infection as tuberculosis and preexisting lung disease should be excluded. These agents have been linked to pulmonary nodules, pneumonitis, fibrosis, autoimmune reactions and infection. We report a case of adalimumab induced organizing pneumonia in an old gentleman who was started on the drug for his uncontrolled Psoriasis.