Pulmonary arteriovenous malformation (AVM) is a rare vascular malformation of the lung that carries a considerable risk of serious complications such as cerebral embolism, brain abscess, and pulmonary hemorrhage. Embolization with coils or detachable balloons is currently the preferred treatment. Paradoxical embolization of coils and balloons may occur, especially in patients with large feeding arteries. This report describes an initial experience with the use of the Amplatzer Vascular Plug used for endovascular treatment of bilateral multiple pulmonary AVMs in an adult patient. © SIR, 2006.