Hemoptysis is quite common in primary pulmonary disease, including tyberculosis and carcinoma, as well as in congenital heart disease. Rescently the authors had experienced a case of massive hemoptysis soon after extracorporeal circulation during open heart surgery. The patient had been diagnosed as pulmonary tuberculosis and triology of Fallot. After surgical procedure for pulomonary stenosis and A.S.D, massive hemoptysis occurred abruptly through the endotracheal tube and B.P. took a sudden fall by 40 Torr/systolic pressure. Bleeding source was proved to be on the left upper lobe. So left upper lobetomy had to be performed to control this massive hemoptysis.