Accurate biopsy-based diagnosis of pulmonary lesions is crucial for define the histological type and adequate planning treatment. Many technologies have advanced in bronchoscopy to improve the diagnosis of lung lesions. However, sometimes the diagnosis of lung lesions is not achieved by bronchoscopy or endobronchial ultrasound, and the patient is submitted to invasive procedures such as thoracotomy or thoracoscopy, presenting postoperative complications and longer hospital stay. This case shows the successful diagnosis made by endoscopic ultrasound (EUS) with transesophageal puncture of a pulmonary nodule. A 71-year-old man previously treated for a rectal tumor needed histological diagnosis of a pulmonary nodule, seen on follow-up tomography. Due to its proximity to the esophagus, a transesophageal EUS puncture was indicated. The procedure had no complications and the histological analysis confirmed metastasis of a rectal adenocarcinoma.This is an example that EUS is safe and effective in diagnosing some lung lesions through transesophageal assessment and puncture.