Objective To discuss the clinical features of trachea and bronchial tuberculosis and estimate the efficacy of the diagnosis of trachea and bronchial tuberculosis by fiberoptic bronchoscopy. Methods Clinical presentations and examination of fiberoptic bronchoscopy findings of 216 patients diagnosed by Olympus electric or fiberoptic bronchoscopy were retrospectively investigated. Results Male of the 216 patients were 95, female were 121, with 1.27 times higher incidence noted in female than in male subjects. An activator dry cough was the most complain in 72.7% , intermittent hemoptysis was in 34.7% , absenting of typical clinical poisoning symptoms of tuberculosis. Atelectasis and shape in lung were the most common chest roentgenographic presentations respectively in 31.0 % and 24.1 %. Chest roentgenographic presentations of 16.7% were normal. Bronchoscopic findings showed that main pathologic changes included 36.1% granulation, 31.0% mucosa inflammation, 24.1% ulceration (or necrosis) and 8. 8% cicatricial stenosis, left lung (56. 2%) was more often affected than right lung (37.6%), left bronchi (26.9% ) was in the first. The pathologic changes affected all of leaf, segment bronchi. One hundred and seventy-eight cases (82.4%) were diagnosed by bronchoscopic biopsy, 68 cases (31.5%) were diagnosed by bronchoscopic brushing examination for acid - fast bacillus. Conclusion The clinical features of trachea and bronchial tuberculosis are non - specific and easy to be misdiag-nosed. It is the main reason to be misdiagnosed that bronchial biopsy is neglected by clinical doctors. Bronchial biopsy should be the most reliable and accurate step to get the definite diagnosis.