Vaping-triggered diffuse alveolar haemorrhage (DAH) is rarely reported in the literature. We report the case of a 60-year-old man who presented to the emergency department with hemoptysis. He had a known history of chronic liver disease and presented with coagulopathy. He was an active smoker with a cumulative tobacco exposure of 12.5 pack-years and had been using nicotine-containing e-cigarettes for the past 10 months. Initial chest radiograph revealed bilateral infiltrates and high-resolution computed tomography (HRCT) of the thorax demonstrated bilateral, nodular, multifocal ground-glass opacities. Bronchoalveolar lavage (BAL) showed a progressively bloody return, consistent with diffuse alveolar haemorrhage (DAH). Coagulopathy was managed using targeted therapy guided by Rotational Thromboelastometry (ROTEM). Despite aggressive management, the patient succumbed to septic shock on the ninth day of admission. The pathogenesis of vaping-induced DAH may involve direct vascular injury from heated chemicals or an indirect mechanism via inflammatory cascades triggered by inhaled chemicals. In our patient with chronic liver disease complicated by coagulopathy, vaping triggered diffuse alveolar haemorrhage. This case highlights that vaping exposure may trigger DAH in patients with predisposing conditions such as severe coagulopathy due to chronic liver disease.