Blood in mouth sputum is very common in clinical practice and needs to be analyzed and identified from different causes, first of all from oral problems. If the patient has chronic oral inflammation, such as gingivitis, calculus, etc., it can cause blood in the oral sputum, especially when waking up in the early morning. In addition, the tendency of bleeding gums caused by systemic blood system diseases has to be excluded, which can be initially identified by routine blood tests. At the same time, it is also necessary to see if the blood in the sputum is caused by the inflammation of the throat. If necessary, CT examination of the chest can be done to rule out chest diseases, such as common tuberculosis, which can show blood in sputum, and bronchiectasis, which can also show blood in sputum. If the patient has been smoking for a long time, the possibility of lung cancer should also be excluded, which needs to be clarified by imaging and pathogenic examination. Therefore, the different cases should be carefully identified and then treated accordingly.