The term “black bronchoscopy” is used to describe the black pigmentation of the airways. It is a rare condition with multiple etiologies. We describe a case of a “black bronchoscopy” due to severe soot deposition as a result of smoke inhalation during a household fire in a 71-year-old woman. Early flexible bronchoscopy allowed for a precise diagnosis of severe inhalation injury, and bronchial lavage was carried out to remove soot casts to reduce complications. Any patient suspected of having smoke inhalation injury should undergo early bronchoscopy to allow for a precise diagnosis, staging, and more aggressive treatment measures as the mortality among patients exposed to smoke with inhalation airway injury is high.