We describe a case of proven transmission of SARS-CoV-2 from lung donor to recipient . The donor had no clinical history or findings suggestive of infection with SARS-CoV-2 and tested negative by reverse transcriptase polymerase chain reaction (RT-PCR) on a nasopharyngeal (NP) swab obtained within 48 hours of procurement . Lower respiratory tract testing was not performed . The recipient developed fever, hypotension and pulmonary infiltrates on post-transplant day 3, and RT-PCR testing for SARS-CoV-2 on an NP swab specimen was non-reactive, but positive on bronchoalveolar lavage (BAL) fluid . One thoracic surgeon present during the transplantation procedure developed COVID-19 . Sequence analysis of isolates from donor BAL fluid (obtained at procurement), the recipient, and the infected thoracic surgeon proved donor origin of recipient and health care worker infection . No other organs were procured from this donor . Transplant centers and organ procurement organizations should perform SARS-CoV-2 testing of lower respiratory tract specimens from potential lung donors, and consider enhanced personal protective equipment for health care workers involved in lung procurement and transplantation.