Coccidioidomycosis is a common infectious disease in southwestern North America, which is caused by the soil fungus, Coccidioides immitis. Due to the mobility of the modem population, increasing numbers of cases are being diagnosed outside the endemic areas. Moreover, diagnosis in non-endenmic areas may be delayed or confused due to its rarity. Here we report a case of pulmonary coccidioidomycosis in an immigrant. The patient presented with unexplained pulmonary symptoms. A history of recent travel to or immigration from an endemic area may suggest coccidioidomycosis. In addition an early tissue biopsy is helpful in establishing this diagnosis.