Background <p>E-cigarette or vaping product use-associated lung injury (EVALI) emerged as a serious public health concern following outbreaks in North America, but remains underreported in Latin America. This study aims to describe the clinical, radiologic, and histopathologic features of EVALI in a tertiary care center in Bogotá, Colombia.</p> Methods <p>We conducted a retrospective case series of patients hospitalized with suspected EVALI between January 2020 and July 2024. Inclusion criteria followed CDC guidelines: history of vaping in the last 90 days, radiographic abnormalities (notably ground-glass opacities), and exclusion of alternative diagnoses. We analyzed demographic, clinical, imaging, and histopathologic data, including ICU admissions and outcomes.</p> Results <p>Twenty-five patients met CDC criteria for EVALI. The mean age was 30 years; 80% were male. Most (72%) reported exclusive e-cigarette use, primarily nicotine-based. Informal sourcing of vaping liquids was reported in 28%. The most common symptoms were cough (88%), dyspnea (80%), and fever (76%). Imaging revealed bilateral ground-glass opacities in 88%. ICU admission was required in 76%, and 8% needed mechanical ventilation. Bronchoscopy and/or lung biopsy confirmed organizing pneumonia or acute interstitial inflammation in selected cases. All patients received corticosteroids with clinical and radiological recovery; no deaths occurred, however causality cannot be inferred from this retrospective series.</p> Conclusions <p>This is one of the largest EVALI case series reported in Latin America. Our findings underscore the importance of early recognition and management of EVALI in low- and middle-income countries, particularly amid increasing e-cigarette use among youth. Public health policies must address informal vape markets and misinformation surrounding product safety.</p>