Desquamative interstitial pneumonia (DIP) is a smoking-related interstitial lung disease. It usually develops in males, and presents with insidious exertional dyspnea and persistent nonproductive cough. Chest computed tomography usually shows diffuse ground-glass opacities in bilateral lungs. Here, we report a case of massive hemoptysis with right middle lobe (RML) consolidation and diffuse centrilobular ground glass opacities. The hemoptysis resolved after RML wedge resection, steroid therapy and smoking cessation. Hemoptysis and lung consolidation are rare presentations in patients with DIP. This case serves to remind us that tissue proof via surgical biopsy is of value in diagnosing interstitial lung disease, if less invasive examinations fail to obtain a definite diagnosis.