Introduction: Varicella pneumonitis is a rare but lethal complication of varicella zoster infection. Case description:We report a case of a 42 year old gentleman who presented with fever, rash, cough and worsening shortness of breath after exposure to his daughter who just recovered from varicella zoster infection. He is an active smoker with no comorbidities. He presented on day 4 of illness with generalised vesicular eruption and respiratory examination revealed reduced vesicular breath sounds bilaterally. He was intubated in view of worsening respiratory distress and was transferred to ICU. Chest X-ray and ABG was suggestive of acute respiratory distress syndrome(ARDS). He was treated with IV Acyclovir and broad spectrum antibiotics in view of subsequent hospital acquired infection. He was discharged well after 3 weeks of hospitalisation. Discussion: Varicella zoster infection is caused by Human alpha-herpesvirus 3, one of eight herpes viruses known to infect humans. Diagnosis of varicella pneumonitis with ARDS was made on the basis of rash, respiratory symptoms and contact with a child who just recovered from varicella zoster infection and rapid worsening of radiological changes. The risk factor of developing severe pneumonitis can be attributed to active smoking. Conclusion: High degree of suspicion and timely diagnosis is crucial for a favourable outcome in a patient with this rare complication.