On 7 December 2007, the Hebei Spirit ran aground near Taean and released approximately 10,900 tons of oil into the sea. Crude oil on the coastal areas and fumes in the a ir increased the number of health problems among the local population. We report a case of respiratory failure a fter the oil spill clean-up work. A 66-year-old female was admitted to hospital with cough, sputum, and dyspnea of 1-m onth duration after the oil spill clean-up. She was diagnosed with community-acquired pneumonia and treated with empirical antibiotics. However, she had progressive respiratory failure without identification of the p athogen. Respiratory failure due to chronic inhalation of hydrocarbons from the crude oil spill clean-up was suspected . After mechanical ventilation care, she recovered from respiratory failure and was discharged. We report a case o f severe respiratory toxic effects after an oil spill clean-up. We concluded that long-term hydrocarbon inhalation during the oil spill clean-up may have induced respiratory failure in this case.Key Words: Petroleum, Hydrocarbons, Respiratory insufficiency