Hemoptysis, or coughing of blood, oftentimes triggers anxiety and fear for patients. The etiology of hemoptysis will determine the clinical course, which includes watchful waiting or intensive care admission. Any amount of hemoptysis that compromises the patient's respiratory status is considered massive hemoptysis and should be considered a medical emergency. In this article, we review introduction, definition, bronchial circulation anatomy, etiology, and management of massive hemoptysis.