Endobronchial tuberculosis (EBTB) is a tuberculous lesion that occurs in the mucosa or submucosa of the bronchus. Its clinical and radiographic manifestations are atypical, and it is easy to be misdiagnosed clinically, thus delaying treatment and leading to irreversible bronchial stenosis and pulmonary atelectasis. EBTB is a tuberculosis that occurs in the mucosa and submucosa of the trachea and bronchi and is often caused by the implantation of tuberculosis bacilli in the bronchi, or by infiltration and rupture of the adjacent affected mediastinal lymph nodes into the bronchi, or by hematogenous dissemination. About 10-40% of patients with active tuberculosis have EBTB in combination, and more than 90% of patients with EBTB may have bronchial stenosis, while 10-20% of patients with EBTB may have a completely normal chest radiograph. Delayed treatment of EBTB can lead to tuberculous bronchial stenosis, resulting in severe dyspnea, atelectasis, and secondary pneumonia, and early antituberculosis can prevent these complications. Misdiagnosis of the disease can not only lead to the spread of TB in the population, but also increase the difficulty of curing the disease, which often ends up requiring surgery to cure, increasing the suffering and financial burden of the patient. Therefore, it is important to improve the level of early diagnosis of EBTB. Patients diagnosed with EBTB have obvious respiratory symptoms, with a pronounced cough and little sputum production, and only a few patients present with fever, while there are more patients with chest tightness. Clinical symptoms lacked specificity and there were no obvious symptoms of TB toxicity such as wasting and night sweats. On physical examination, most patients had limited inspiratory croup (60%), but there were still patients with no positive signs. The results of Park et al. showed no increase in airway reactivity in patients with EBTB and suggested that normal airway reactivity could be a basis for differentiating asthma from EBTB, which is consistent with the findings of this study. Fiberoptic bronchoscopy plays a decisive role in the diagnosis of endothelia tuberculosis. Unlike pulmonary tuberculosis, which is often found in the post-apical and dorsal segments of the upper lobe, EBTB can involve the trachea and the bronchi of both lungs, indicating the multifocal nature of EBTB. edema, fibrous stenosis, mass, granular, ulcerative, and nonspecific bronchitis subtypes. In our opinion, it is more scientific to classify according to the latter, because the latter classification is more detailed, and different diagnostic and therapeutic methods are adopted for different classifications to facilitate clinical observation of the efficacy. Domestic and foreign literature reported that the positive rate of sputum and transbronchial brush smear for antacid bacilli was not high, but the positive rate of brush test in our group was 80%, which was significantly higher than that of biopsy, probably related to the fact that most of the lesions in our group were early changes of EBTB. If the brush test and biopsy are combined, the diagnostic rate will be significantly improved. For patients with sputum-positive primary TB, as long as early, reasonable, regular, combined and full course medication is given, the sputum-negative rate and lesion cure rate can reach more than 95%, but for sputum-positive EBTB, the efficacy of systemic chemotherapy alone was considered poor in the past, and EBTB patients with normal chest films were given more than 1 year of regular systemic anti-TB treatment, and all patients had remission of symptoms and normal chest films on review, and some patients This suggests that systemic antituberculosis chemotherapy is effective for EBTB with normal chest radiographs. We believe that the reason for the poor efficacy of EBTB is related to the untimely diagnosis and treatment. The good efficacy of systemic chemotherapy alone, which cured all the patients, may be related to the fact that the treated patients had mild lesions and were not combined with other sites of tuberculosis, and also indicates the importance of early diagnosis and treatment to cure the lesions in a reversible stage. We believe that EBTB with normal chest radiographs should be cured with adequate, effective, combined, regular and complete anti-tuberculosis treatment. At present, there are different views on the medical treatment of EBTB at home and abroad. Some domestic authors emphasize local treatment with anti-tuberculosis drugs, while foreign countries propose that treatment with nebulized inhaled glucocorticoids and streptomycin can be used, but there are also controversies. The side effects of glucocorticosteroids and the possibility of damage caused by the stimulation of the bronchial mucosa by anti-tuberculosis drugs have not been systematically studied, which should be taken into account. In conclusion, at present, EBTB still lacks specific clinical features. To reduce misdiagnosis and underdiagnosis of EBTB, in our clinical work, for those with unexplained respiratory symptoms such as cough, chest tightness, blood in the sputum, asthma, and sputum, if anti-inflammatory and symptomatic treatment is ineffective for 2 weeks, fiberoptic bronchoscopy should be performed promptly. Microscopic biopsy and brushing are important to improve the diagnosis rate of EBTB and avoid misdiagnosis. Systemic chemotherapy for EBTB with normal chest radiographs is effective and can cure the disease and avoid complications.