Massive hemoptysis remains a critical clinical emergency that requires prompt identification, stabilization, and coordinated management. This chapter reviews the anesthetic considerations for patients undergoing interventional pulmonary procedures in the context of hemoptysis. It highlights preoperative assessment, airway management strategies, vascular anatomy, and intraoperative challenges, including lung isolation and bleeding control. Emphasis is placed on a multidisciplinary approach, integrating anesthetic and procedural planning to optimize patient outcomes.