Pulmonary anthrax (also known as inhalation anthrax) is a rare and fatal clinical type of anthrax. This paper reports the clinical characteristics as well as diagnostic and treatment processes of a case of inhalation anthrax caused by Bacillus anthracis. The patient presented with fever, chest tightness, dyspnea, and difficulty in breathing as the main clinical manifestations. Imaging examination revealed mediastinal lymphadenopathy and bilateral pleural effusion accompanied by pulmonary space-occupying lesions. Metagenomic sequencing of lung tissue and bronchoalveolar lavage fluid detected specific sequences of Bacillus anthracis, and nucleic acid test was positive. Combined with the epidemiological history, clinical manifestations, and laboratory test results, the diagnosis of pulmonary anthrax was confirmed. The patient’s condition stabilized after standardized anti-infective treatment. This paper combines literature review to explore the clinical characteristics, laboratory diagnosis, and treatment scheme for Bacillus anthracis infection, aiming to enhance healthcare workers’ ability to identify anthrax early and improve their awareness on preventing and controlling healthcare-associated infection.