Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare precursor of neuroendocrine malignancy. Diagnosis is difficult as clinical and radiological findings can be non-specific. Histological confirmation is necessary, and surgical lung biopsy is still considered the gold standard technique to aid multidisciplinary discussion. There are increasing reports of using transbronchial lung cryobiopsy (TBLC) for tissue sampling, allowing a feasible and safe alternative to diagnosis. Here we present a case of cough, dyspnoea and hypoxia in a woman ultimately diagnosed with DIPNECH using TBLC.