In the last decade lung transplantation has become a realistic option for selected patients with many end-stage lung diseases. Annual activity has steadily increased, and the results have been good. The limitations, however, have become apparent, too. The principal causes of morbidity and mortality after lung transplantation have been infection and allograft rejection, but the bronchial anastomosis is still a vulnerable site. Because of its diagnostic and therapeutic versatility, bronchoscopy plays a central role in the management of lung transplant recipients.