Spitting up black sputum in the morning may be due to excessive dust inhalation or coughing up blood. In the former case, it is sufficient to avoid further inhalation of dust, while in the latter case, it is necessary to further improve the relevant examination to clarify the diagnosis and what kind of disease is causing the coughing up of blood. Clinical diseases that can cause coughing up blood include tuberculosis, lung tumor, bronchiectasis, and severe pneumonia. If the patient coughs up blood due to tuberculosis, anti-tuberculosis treatment is required. If the patient coughs up blood due to lung tumor, surgical treatment, radiotherapy, chemotherapy, target cell drug therapy, etc. can be considered. If the patient is coughing up blood due to bronchiectasis, anti-infection, expectorant and, if necessary, hemostatic treatment are required. If the coughing up of blood occurs due to severe pneumonia, aggressive anti-infection is needed, and supportive symptomatic treatment can be given at the same time.