We describe a case of pulmonary injury and pulmonary hypertension induced by gold therapy. To our knowledge, this is the first report of pulmonary hypertension due to gold therapy. In this case, type 4 allergic reaction to gold sodium thiomalate is evidenced, pulmonary hypertension decreased gradually with oxygen therapy, and pulmonary injury was improved with corticosteroids. In patients with gold therapy, great attention must be paid to gold-related pulmonary injury and pulmonary hypertension.