Metastatic pulmonary calcification (MPC) is defined as the deposition of calcium salts in healthy tissues.1Such soft-tissue calcification can occur in the stomach, kidneys, lungs, heart, and blood vessels, with the lungs being particularly susceptible to such an occurrence. MPC can be a result of both benign and malignant causes. Benign causes include chronic renal insufficiency on dialysis, orthotopic liver transplantation, primary hyperparathyroidism, excess exogenous administration of calcium and vitamin D, hypervitaminosis D, osteopetrosis, and osteitis deformans. Malignant causes of MPC include parathyroid carcinoma, multiple myeloma, lymphoma/leukemia, hypopharyngeal squamous cell carcinoma, synovial carcinoma, breast carcinoma, and choriocarcinoma. The most common benign cause of MPC is seen in patients receiving hemodialysis for the treatment of chronic renal insufficiency. At autopsy, MPC has been found in 60 to 75% of patients undergoing hemodialysis.2–3 The purported mechanism is that of an increased calcium-phosphate product as a result of acidosis leaching calcium and phosphate from the bones, secondary (and later tertiary) hyperparathyroidism causing increased calcium and phosphate release from the bone, and a decrease in phosphate excretion as a result of a fall in the glomerular filtration rate.4The intermittent alkalosis that often accompanies bicarbonate hemodialysis predisposes the patient to soft-tissue precipitation of calcium salts.5Furthermore, a challenging agent such as tissue injury or physical stress is thought to precipitate pulmonary MPC.6 Most reports of MPC have been in patients undergoing hemodialysis, and to date there has been no literature available on its incidence in patients undergoing peritoneal dialysis.