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Two cases of pulmonary vascular anomaly in unrelated adult alpacas (Vicugna pacos) are described. In the first case, a 9-year-old intact male alpaca presented at Oregon State University Veterinary Teaching Hospital with bilateral epistaxis and died the subsequent day following severe hemorrhage from the mouth and nostrils. At necropsy, a tortuous vascular lesion was identified in the right cranial lung lobe, associated with hemorrhage into airways. In the second case, a 2-year-old female alpaca presented with postpartum anorexia, opisthotonus, and recumbency. In this second case, a similar vascular lesion was identified in the right cranial lung lobe but without associated hemorrhage. Histopathological examination of the lesion in both cases revealed numerous dilated, irregular blood vessels with marked variation in wall thickness within vessels, surrounded by foci of extramedullary hematopoiesis. Diagnoses of locally extensive pulmonary vascular anomalies (arteriovenous malformations) were made.