We report a case of hemoptysis observed in a 32-year-old man with an uneventful past history. Flexible bronchoscopy demonstrated presence of a leech attached to the laryngeal orifice. This condition is common in endemic areas but is underdiagnosed. The association of hemoptysis, voice alterations, and difficult respiration are suggestive signs. Extraction should be achieved rapidly to avoid death from asphyxiation or acute respiratory failure.