Tsutsugamushi disease is an acute febrile systemic disease caused by Rickettsia tsutsugamushi. Attention to Tsutsugamushi disease is increasing as it has recently been known that tsutsugamushi disease is one of the epidemic febrile disease that occur in late fall in Korea. We analysed chest radiographic findings of 60 serologically confirmed Tsutsugamushi disease patients. 47 (78%) of the 60 patients showel chest radiographic abnormality 43 patients showed bilateral diffuse pulmonary infiltration mostly reticulonodular interstitial pattern. High resolution CT in a patient strongly supported that the lesions are interstitial location.29 patients (62%) showed findings of hilar lymphadenopathy and septal lines were seen in 22 patients (47%) Other findings were cardiomegaly (10 patients) pleural effusion (6 patients) mediastinal lymphadenopathy (3 patients) Diffuse bilateral interstitial lung infiltration hilar lymphadenopathy and septal lines are typical chest radiographic findings of Tsutsugamushi disease.