A man in his 40s, a current smoker, has worked as an artisanal Okinawan wheat flour noodle chef for the past four years. After starting to use sprinkling flour with oxidized starch as the main component for noodle making, he developed fever, cough and exertional dyspnea. He was diagnosed with non-fibrotic hypersensitivity pneumonitis based on the findings of high-resolution computed tomography (HRCT), bronchoalveolar lavage (BAL) fluid analysis, and transbronchial lung biopsy (TBLB). The lymphocyte stimulation test for the sprinkling flour yielded a positive result, symptoms were not induced during exposure at home or at work, nor during noodle-making without the use of sprinkling flour. After discontinuation of sprinkling flour usage, there was no recurrence. Although anti-Trichosporon asahii antibody and bird-specific IgG antibody were also positive, and there was a history of exposure to chemical sprays, making it difficult to identify the antigen, flour was considered as one possible causative antigen.