Neurogenic pulmonary edema (NPE) is a rare clinical entity that is seen in the setting of epileptic seizure, head injury and cerebral hemorrhage. NPE in the setting of transient ischemic attack (TIA) has not been reported before. Here we report the case of a 67 year old female with TIA complicated with NPE. NPE has been reported to occur predominantly in the setting of epileptic seizure, head injury and cerebral hemorrhage. Other presentation may be rare, but may occur and require emergent diagnosis and treatment when they do.