Cocaine smoking can cause a number of medical complications. Pneumomediastinum and pneumothorax due to barotrauma have been the most common radiographic abnormalities reported in the medical literature. The hospital records of five patients with pulmonary edema who smoked cocaine just before admission were reviewed. Except for cocaine abuse no other possible cause for the pulmonary edema was found. Although chest radiographic abnormalities in these patients are uncommon, these cases are reported to inform the radiologist of this possible complication of cocaine smoking. The presence of pulmonary edema in a young, otherwise healthy patient without predisposing risk factors should alert the radiologist to the possible diagnosis of cocaine abuse.