CASE PRESENTATION: A fifty-one-year-old woman with history of poorly-controlled asthma was referred to pulmonology clinic for evaluation of chronic cough and wheezing. Initial work-up included a chest x-ray revealing prominent interstitial markings, an elevated IgE level and a negative anti-nuclear antibody. The patient was started on Spiriva without improvement. Computed tomography of the chest was performed, displaying interstitial lung disease, concerning for HP. Upon further questioning, the patient had an indoor pet bird, further strengthening the suspicion for HP. An HP panel (aspergillus fumigatus, micropolyspora faeni, thermoactinomyces vulgaris, aurebasidium pullilans, thermoactinomyces sacchari, and pigeon serum) was negative, however, causing the patient to question the underlying etiology of her symptoms.The patient was instructed to remove the bird from her house, but was hesitant to do so given her negative HP panel. To rule out other etiologies, bronchoscopy with BAL was performed. Results yielded elevated lymphocyte and eosinophil counts, but negative cultures. These findings were consistent with a diagnosis of HP. At follow-up, the patient’s clinical course had deteriorated and she required supplemental oxygen. The patient was treated with steroids, and was again instructed to remove the bird from her home. Reluctantly, the patient did so. One month later, the patient’s chronic respiratory symptoms had improved. She no longer required supplemental oxygen.