Although the gastrointestinal tract is the most common site of Aeromonas infection, extraintestinal sites such as the respiratory tract have been rarely reported. Herein, we report an uncommon case of bacteremic pneumonia with A. hydrophilia in a 50-year-old man with oral cavity cancer undergoing concomitant chemoradiotherapy. He presented with initial oral cavity bleeding and massive aspiration, followed by acute respiratory failure. The clinical condition rapidly deteriorated in spite of antibiotic use and intensive care, and the patient died three days after admission.