Non-01 Vibrio cholera typically produces intestinal illnesses similar but less severe than cholera produced by type 01 vibrios. Occasionally the site of infection is extraintestinal and may become severe or even life threatening. Classically this organism is found in a saltwater environment and infection is linked with saltwater contact or seafood ingestion. Here we present 2 cases of primary pulmonary non-01 Vibrio cholera infection. The organisms from these two cases were compared by pulse field gel technique and found to be different. These infections occurred in immunocompetent persons who aspirated fresh, flowing water from the same river source. These cases serve to alert critical care and emergency physicians to the possibility of Vibrio cholera as a cause of aspiration pneumonia and bacteremia in trauma victims.