So-called peribronchial cuffing in acute pulmonary edema appears to be caused by edema involving the bronchial wall and the peribronchial interstitial space and this was confirmed at autopsy in a patient with acute left heart failure. Edema of the bronchial wall indicates transudation from capillaries derived from the bronchial rather than the pulmonary artery, which may well explain all of the radiological manifestations of acute interstitial edema. The possible role of this circulation in the production of acute alveolar edema is discussed. The significane of the bronchial artery circulation in the production of acute pulmonary edema warrants reevaluation.