As many as 6% of reported cinnamon poisonings cause significant clinical effects, however descriptions of pulmonary toxicity have not yet been reported. Here, we present a pediatric patient’s hospital course following powdered cinnamon aspiration. The early presentation with hypercapnia and lower airways obstructions evolved to hypoxemic respiratory failure and severe pediatric acute respiratory distress syndrome requiring a 7-day course of veno-venous extracorporeal membrane oxygenation, 16 ventilator-days, and 3 diagnostic and therapeutic bronchoscopies with 2 applications of surfactant therapy. The sum of these modalities contributed to this patient’s survival and subsequent return to respiratory baseline 6 months post-hospitalization.