Hemoptysis is not a separate disease; rather it is a manifestation of multiple pathologic processes. Despite the potentially fatal outcome of hemoptysis, the underlying disease is usually otherwise benign and treatable.1–3 The risk of death is particularly high when hemoptysis is massive, and some investigators4–6 estimate the risk of mortality with untreated massive hemoptysis to be in excess of 75%. Others7–8 have found the risk of death to be lower and have advocated an initially conservative approach, although there may be significant mortality from subsequent bouts of hemoptysis in these patients. Some of the variation in mortality risk is due to the lack of the common definition of the term massive. However it is defined, it is clear that massive hemoptysis represents a significant and immediate risk to these patients.