TRALI is a post-transfusion acute respiratory distress syndrome that presents as acute non-cardiogenic pulmonary edema occurring within six hours after a transfusion. A 38-year-old female patient was hospitalized in intensive care for the management of postoperative complications following the resection of a parieto-occipital PEIC, complicated by intraoperative hemorrhagic shock requiring the transfusion of 2 units of red blood cells and 2 units of plasma. Preoperatively, the clinical and biological examination was unremarkable. Under general anesthesia, the estimated blood loss of 1000ml required transfusion of 2 units of packed red blood cells and 2 units of fresh frozen plasma. At 4 hours post-transfusion and 3 hours postoperatively, she developed respiratory distress associated with macroscopic hematuria. She exhibited diffuse bilateral crackles with fine wheezing. Oxygen saturation was 65% under mechanical ventilation. Blood gases showed hypoxemia with hypercapnia. Laboratory tests revealed anemia with Hb: 6.9 g/dl, thrombocytopenia at 59,000/mm³, AST 148.9, ALT 302.1. Transthoracic ultrasound was normal. Thoracic CT angiography showed findings consistent with acute lung injury edema. Furosemide 40 mg was administered every 6 hours for 3 days, in combination with nebulization sessions and corticosteroid therapy. After 24 hours of treatment, the progress was satisfactory with normal saturation. At 72 hours, the lung fields, CT scan, and laboratory results had returned to normal. TRALI is a syndrome whose clinical diagnosis involves identifying pulmonary edema without a hemodynamic or cardiac component