Objective Fiberoptic bronchoscopy (FOB) is a widely used tool in the diagnosis and treatment of pulmonary diseases. However, little is known regarding the indications and diagnostic yield of FOB in Ethiopia. The objective of this study was to determine the indications and diagnostic yield of FOB at Tikur Anbessa Specialized Hospital (TASH), the largest public health hospital in Ethiopia. Results In this retrospective chart review, all patients undergoing FOB between January and December 2013 in the bronchoscopy suite were studied. Data included: patient demographics, smoking, HIV status, procedure indications, and microbiologic, cytological and pathologic results. During the study period, 141 patients underwent FOB. The mean age was 42 years; 90(63%) were men. Among those whose smoking status was known, 15% were current or former smokers. The most common indications for FOB were: lung mass (presumed malignancy) 54% (76), tuberculosis 13% (18), and pleural effusion with possible underlying lung cancer 9%(13). 65 patients had endobronchial and/or transbronchial biopsies; 48% (31/65) were diagnostic and of these 68% (21/31) had malignancies. 57 patients had BAL performed; 33% (19/57) were diagnostic and of these 37% (7/19) had tuberculosis. We found that bronchoscopy was a safe and effective tool for diagnosing lung disease in Ethiopia.