In the past, bronchoscopy has played a vital role in the diagnosis and treatment of pulmonary abscess. However, the fear of aspiration of abscess contents, the advancement of antimicrobial therapy, and the development of radiologic-guided percutaneous drainage of abscess cavities has challenged the endoscopist to define a role in the treatment of this disease. We reviewed the literature to determine if bronchoscopy is effective and safe in the treatment of patients with a pulmonary abscess.