Abstract: We describe the first and rare case report of a cryptogenic organizing pneumonia (COP) in a seventh decade diabetic and hypertensive women from low highlands, Jazan, Saudi Arabia. The evidence of the clinical scenario, laboratories testing , radiological images findings followed by treatment with steroid is quite enough to diagnose COP, irrespective of lung tissue biopsy procedures and processing accessibility for histopathology, in a timely manner as reveals in Yahya Al-FIFI’s diagnostic criteria for cryptogenic organizing pneumonia (COP) without a lung tissue histopathology. We started a methylprednisolone forty milligram intravenously every eight hourly for seven days which is showing a dramatic clinical improvement within initial twenty-four hours of first seven days and complete recovery clinically and radiologically, at the end of the following fourteen days of tapering prednisolone doses without a relapse for seven months. Our successful experience approach in this case of COP has several advantages include that an early diagnosis and introduction of methylprednisolone may lead to preserve lung function, avoidance of biopsies procedure complications, may prevent relapses, early hospital discharge, improve the morbidity, mortality and the quality of life of the patient. So, we conclude these clinical, laboratories testing, and radiological findings are quite enough to diagnosing and treating with methylprednisolone to rescue patient life, when a lung biopsy performance accessibility or feasibility is obscured or delayed. We observe that beta-lactam; ceftriaxone and piperacillin/tazobactam, glycopeptide; vancomycin and macrolide; clarithromycin antibiotics are not effective in our patient COP case scenario. “Yahya Al-FIFI’s diagnostic criteria for cryptogenic organizing pneumonia (COP) without a lung tissue histopathology is easy and sufficient enough to assess physician to diagnose COP in acceptable time frame and may have favorable outcome over all.