We recently encountered a patient presenting with a solitary nodule on chest radiograph. The solitary pulmonary nodule (SPN) has extensive differential diagnosis, including both benign and malignant etiology. Management is frequently challenging. After wedge resection, the nodule was proven to be sarcoidosis. In Taiwan, sarcoidosis presenting as a SPN has never been documented. Recognition of this phenomenon aids in the proper diagnosis and subsequent conservative management. We wish to report this case to alert clinicians, radiologists and pathologists that solitary pulmonary nodule can develop in the lung in patients with sarcoidosis with or without hilar lymphadenopathy.