Skeletal fractures and their surgical manipulation might result in the potentially fatal complication known as fat embolism syndrome (FES). The majority of patients with FES will show up 24 to 72 h after the triggering event with acute-onset dyspnea, neurologic impairment, and petechial rash. Very rarely, FES may present as haemoptysis and diffuse alveolar haemorrhage. We present a case of a 25-year-old male who developed acute-onset breathlessness and haemoptysis following surgery for a traumatic fracture of the distal one-third of the left femur. On detailed evaluation and based on his clinicoradiological profile, he was diagnosed as a case of diffuse alveolar haemorrhage secondary to FES. High clinical suspicion plays a key role in the early diagnosis and treatment of DAH associated with FES. In severe cases, early systemic steroids may result in a good outcome.