When a patient has symptoms of coughing up blood, it may be due to bronchiectasis, tuberculosis, or lung tumor. If the patient is a young adult and also has symptoms of tuberculosis toxicity such as low fever, weakness, night sweats, and wasting, tuberculosis is considered to be more likely. If antacid bacilli are detected in the sputum, the diagnosis of active tuberculosis is clear, and treatment with anti-tuberculosis drugs is required at this time. If the patient is elderly and has a long history of smoking, the diagnosis can be clarified by lung CT, bronchoscopy and puncture biopsy without excluding pulmonary malignant tumor. If the diagnosis of hemoptysis due to pulmonary malignancy is confirmed, surgical treatment, radiotherapy, chemotherapy, target cell drug therapy, etc. can be considered according to the condition.