Three cases of idiopathic primary pulmonary hemosiderosis are reported. Hemosiderin was demonstrated in macrophages (siderophages) in all three cases. In one of them, isotopic examination with radioiron and in an other one, a pulmonary biopsy were performed. All the patients received corticosteroids. The first case had a good evolution in spite of five years without therapy. The second case showed a bad therapeutic response and required immunosuppressive drugs. The third case with a short follow-up is doing well. Literature is reviewed, and considerations about etiopathogeny, clinical features, roentgenographic and therapeutic aspects of the disease are made.