Tropical pulmonary eosinophilia (TPE) is a clinical manifestation of lymphatic filariasis caused by filarial nematodes transmitted by mosquitoes. It results from an immune response to microfilariae trapped in the lungs. Patients present with nocturnal cough, fever, weight loss and marked eosinophilia. Chest imaging may show reticulonodular opacities. Treatment involves diethylcarbamazine to kill the filarial worms along with bronchodilators and corticosteroids for symptoms. TPE must be differentiated from other causes of eosinophilia such as chronic eosinophilic pneumonia.