Broncholithiasis is usually a late complication of tuberculous lymphadenopathy. Clinical symptoms are not suggestive of the condition in most cases, except for lithoptysis which occurs in 5 to 34% of the patients. Owing to the currently low frequency of tuberculosis, broncholithiasis is a rare and sometimes surprising diagnosis, as in the case reported here. In this 65-year old silicotic man, broncholithiasis was manifested by blood-stained expectoration. Fibroscopy established the diagnosis by showing 2 broncholiths, about 1 cm wide, which were endoscopically extracted. The second peculiarity of this case is that broncholithiasis was associated with active tuberculosis.