The combined clinical presentation of acute renal failure with pulmonary hemorrhage is known as pulmonary-renal syndrome. A case of a woman of 78 years olds who presented acute renal failure and pulmonary hemorrhage from the onset of symptoms is described. Renal biopsy and bone marrow aspiration showed nephropathy and an abnormal increase in plasma cells, respectively. The patient was diagnosed with Multiple Myeloma and successfully treated with corticosteroids and plasma transfusions. The presentation of this case indicates the need to consider multiple myeloma as a cause of pulmonary-renal syndrome.