Endobronchial cryotherapy is a versatile bronchoscopic technique with both diagnostic and therapeutic applications. It was initially employed in the treatment of benign and malignant central airway obstruction, where cold energy has destructive effects on the local microcirculation as well as at the cellular level through repeated freeze-thaw cycles that result in a delayed sloughing of tissue and airway relief. Beyond palliation, it is also used for curative treatment of endobronchial microinvasive carcinoma and precancerous lesions. Additionally, cryoadhesion enables the immediate removal of obstructive material such as tumors, mucus plugs, or clots, offering prompt therapeutic benefit. In recent years, its use has expanded to include endobronchial and transbronchial cryobiopsy, which offers superior tissue quality and diagnostic yield compared to conventional forceps. Flexible cryoprobes and emerging techniques such as cryospray and EBUS-guided cryobiopsy have further broadened its clinical utility. Cryotherapy can be safely performed via rigid or flexible bronchoscopy and is particularly advantageous in high-oxygen environments, around airway stents, or in patients with implanted devices. This chapter reviews the mechanisms, techniques, clinical indications, and evidence base for therapeutic use of cryotherapy.