Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease. There is no definitive treatment available. Case; A 13-year-old male with no remarkable medical history presented with a sore throat. Chest X-ray performed because of prolonged symptoms. He referred to pediatric pulmonology department because of the reticulonodular opacities in X-ray. Physical examination was normal and no clinical complaints. X-ray revealed reticulonodular opacities that had a greater distribution in the middle and lower lung zones. PFT showed a mild restrictive pattern. CT images were consistent with interstitial lung disease. The patient underwent open lung biopsy, and histopathologic analysis results confirmed a diagnosis of pulmonary alveolar microlithiasis. The patient started disodium etidronate treatment. Sandstorm-like appearance on chest x-ray decrease and restrictive pattern in PFT improved after three months of treatment. There was no significant change in parenchymal findings on CT. In follow up concomitant thoracic CT and MRG performed. However, the micronodular pattern observed in CT was not present in MRG. <b>Conclusion:</b> There is no known effective treatment for PAM. Number of the report describes the beneficial effects of long-term treatment with disodium etidronate but in a certain case, it seems ineffective. Our patient's chest X-ray and PFT improved after three months of disodium etidronate treatment. However, there was no major change in CT. It is possible to observe parenchymal improvement in long term treatment. CT is a major tool for the detection and follows up the patients. We performed thoracic MRG in follow up however the parenchymal patterns of PAM could not be detected in MRG.