According to the recent On-TIME 2 and MULTISTRATEGY studies, tirofiban may be considered useful in the management of patients with ST-elevation myocardial infarction (STEMI). However, although rare, massive pulmonary hemorrhage is a severe complication associated with tirofiban after percutaneous coronary intervention (PCI). Little related research has been reported in Taiwan. We report a 70-year-old man who was suffering from acute STEMI with proximal left anterior descending artery total occlusion. Tirofiban-related pulmonary hemorrhage after PCI was highly suspected. The symptoms improved after stopping tirofiban. Physicians need to be aware of tirofiban-related pulmonary hemorrhage after PCI.