A 35-year-old male with a connective tissue disorder presented with a 3-day history of shortness of breath. On evaluation patient was found to be hypoxic (oxygen saturation of 46%), with severe respiratory distress. The patient was intubated and initiated on lung protective ventilation. HRCT thorax followed by bronchoscopy proved diffuse alveolar hemorrhage. In view of persistent hypoxemia and a P/F ratio of 55 mmHg, the patient was initiated on prone ventilation. After 6 h of prone ventilation, the patient was on FiO2 of 1.0, respiratory rate of 32/min, and tidal volume of 6 ml/kg, and arterial blood gas (ABG) revealed pH 7.19, pCO2 75 mmHg, pO2 56 mmHg, and SaO2 78%.