Abstract: Acute fibrinous and organizing pneumonia (AFOP) is a recently described and relatively rare type of interstitial lung disease. It is defined by a histologic pattern of intra-alveolar fibrin deposition, along with patchy organizing pneumonia. We report the case of a 53-year-old white woman who complained of fevers, chills, fatigue, shortness of breath, and nonproductive cough for 1 week. She was diagnosed with AFOP on peripheral lung biopsy. Serology revealed a simultaneous or recent infection with Mycoplasma pneumoniae. Although M. pneumoniae infection commonly presents as pneumonia of gradual and insidious onset, it can rarely have a fulminant presentation. This report adds AFOP to the list of rare complications of M. pneumoniae infection.