Abstract: Objective To summarize the treatment experience of emergency operation for pulmonary tuberculosis complicated with massive hemoptysis. Methods Clinical data about 45 inpatients with pulmonary tuberculosis complicated with massive hemoptysis received emergency operation in our hospital from June 2005 to December 2015 were retrospectively analyzed. There were 39 male and 6 female patients with average age of 47.5 years old. Their operation methods included lobectomy and total pneumonectomy. Results Of the 45 patients, one patient died during the operation, one patient died at seven days after surgery because of severe pulmonary infection, and one patient gave up treatment at 13 days after surgery for the respiratory insufficiency and extubation failure. Bronchopleural fistula occurred in two patients during the early stage after surgery, and it turned to be chronic empyema after thoracic rinsing and drainage. The patients survived and discharged with drainage tube. Hemothorax occurred in two patients after operation, then they received surgical hemostasis and recovered. Other 38 patients recovered. Conclusion For patients with pulmonary tuberculosis complicated with massive hemoptysis, immediate pulmonary resection is the key for the success of surgery. Lobectomy is the first choice. Precise management after surgery can effectively prevent complications.