A 23-year-old women present to the emergency room with a one day history of coughing up five cups filled with blood. She complained of a chronic cough for 3 months, loss of weight, and night sweats. Clinical examination detected that the patient was diaphoretic and distressed. She was anemic with a hemoglobin of 6 g/dL and hypotensive with a blood pressure of 100/60 mmHg. The patient was resuscitated and was transfused with 4 units of packed red blood cells to a hemoglobin level of 10 g/dL. Chest X-ray revealed active pulmonary tuberculosis with multiple cavities in both lungs. Sputum was positive for acid-fast bacilli. A CT scan of the lungs confirmed the diagnosis (Figure 1(a)). Focal contrast enhancement in the left lower lobe parenchyma was detected on the contrast CT scan (Figure 1(b)). A pulmonary aneurysm in the left lower lobe was suspected. Once the patient was fully resuscitated, selective bronchial arteriography and pulmonary angiography were performed. A 5 cm diameter oval aneurysm was detected originating from the left lower lobe posterior-medial segment pulmonary artery (Figure 1(c)). The bronchial arteries were not enlarged, and no active contrast extravasation was detected from them. A single Gianturco steel coil 5 mm in diameter was selectively placed at the neck of the aneurysm with occlusion of the pulmonary aneurysm (Figure 1(d)). The patient's hemoptysis resolved over the next 12 hours. The patient was treated with a full course of TB therapy and made a good recovery.