A 60-year-old woman had been receiving treatment for alcoholic hepatitis as an outpatient. She was admitted to a neighboring hospital complaining of dry cough and dyspnea, diagnosed as having a common cold, and given a Saibokuto for 6 weeks before admission. Chest computed tomography (CT) showed diffuse ground-glass opacities with traction bronchiectasis in bilateral lungs. Although she had received methyl-prednisolone pulse therapy, her symptoms deteriorated. She was referred to our hospital because of severe hypoxemia and had required mechanical ventilation on the admission day. In addition to systemic steroid and sivelestat, she had received intravenous cyclophosphamide (IVCY) and intravenous immunoglobulin (IVIG) under extracorporeal membrane oxygenation (ECMO). After these therapies, her symptoms and CT findings improved, and she successfully recovered from mechanical ventilation. A drug-lymphocyte stimulation test for Saibokuto was negative. Considering clinical course, we diagnosed her as having Saibokuto-induced pneumonia. In summary, we successfully treated the case with combination therapy of sivelestat and immunosuppresants, including steroids, IVCY, and IVIG under ECMO.