Purpose of review <p>Bronchiectasis management has traditionally followed a one-size-fits-all approach that overlooks the disease’s marked clinical and biological heterogeneity. This review examines how the treatable traits framework, originally developed for asthma and chronic obstructive pulmonary disease, applies to bronchiectasis, and asks how the recently updated European Respiratory Society Clinical Practice Guideline formalises this precision medicine approach in routine care.</p> Recent findings <p>The updated guideline endorses systematic assessment across pulmonary, aetiological, extrapulmonary, and behavioural/lifestyle domains, emphasising aetiological work-up, exacerbation risk stratification, and individualised pharmacological and non-pharmacological therapy. A newly approved disease-modifying agent for non-cystic fibrosis bronchiectasis, targeting neutrophil serine protease activation, exemplifies this endotype-directed shift toward addressing neutrophilic airway inflammation directly.</p> Summary <p>A structured treatable traits approach translates the guideline’s key messages into actionable, multidomain assessment and treatment. Wider adoption, supported by emerging biomarkers, digital monitoring tools, and an expanding therapeutic pipeline, offers a route to more personalised, outcome-focused care and should inform the design of future bronchiectasis trials.</p>