Hemoptysis, the expectoration of blood from the respiratory tract, poses a significant clinical challenge, particularly in regions where tuberculosis (TB) remains prevalent. This case series explores four patients presenting with hemoptysis, each with distinct etiologies and management strategies. Patient A, a case of relapsed pulmonary tuberculosis, was successfully managed using bronchial artery embolization (BAE) to control massive bleeding. Patient B, with post-TB pulmonary destruction, underwent fluoroscopy-guided arterial embolization for hemostasis. Patient C, experiencing recurrent hemoptysis due to saccular aneurysms, required emergent pulmonary angiography and embolization. Patient D, diagnosed with drug-resistant TB after an initial episode of hemoptysis, responded well to a modified all-oral drug regimen following BAE.