Background: Hemoptysis may vary in degree from just a streaking of blood with sputum to life threatening massive hemoptysis. Massive hemoptysis into the airway is an imminent threat to life because asphyxia occurs as the tracheobronchial tree is flooded with blood. Hemoptysis possesses a great diagnostic challenge because it has been described in many cardio–pulmonary disease and some hematological disorders. Objectives: To study various respiratory etiologies, pathogenesis of different causes of hemoptysis, its clinical implications and also to study demographic factors associated with hemoptysis and various factors related to recurrent hemoptysis. Methodology: A prospective observational study over a period of two years. All participants with hemoptysis were included with some exclusion like patients with bleeding diathesis, bleeding from upper respiratory tract and gastrointestinal tract, and patients on antiplatelet drugs. All patients had undergone a detailed clinical and laboratory examinations like clinical history, physical examination, base line biochemistry, hematological and clotting test, chest X–ray, computerized tomography of chest and bronchoscopy. Sputum of all patients was investigated for organisms and cytopathological examination was also performed to rule out malignancy. Observations: Total 50 patients were enrolled with maximum patients in the age group of 31 to 50 years of age (76%) with male predominance (76%), 76% participants with positive smoking history. Etiology wise distribution of all participants show 70% patients had active or healed pulmonary tuberculosis and 10% had bronchiectasis and 4% participants had bronchogenic carcinoma. Conclusion: Pulmonary tuberculosis is still the major cause of hemoptysis and other respiratory diseases like bronchiectasis and bronchogenic carcinoma are also common etiologies for the hemoptysis.