Abstract: Objective To explore the treatment course of injecting anti tuberculosis drugs into the endotracheal focus by fiberoptic bronchoscopy for the patients with tracheobronchial tuberculosis. Methods A total of 82 patients who were first diagnosed with tracheobronchial tuberculosis (type Ⅰ-Ⅲ) in the respiratory department of our hospital from January, 2014 to December, 2016 were selected, and divided into two groups by random digital table method, with 42 cases in the observation group and 40 cases in the control group. Both groups of patients were given 2HREZ/10HRE chemotherapy. At the same time, the patients in the observation group (42 cases) were injected with rifampin (0.3 g/branch) and isoniazid (0.1 g/branch) in the trachea by the bronchoscope for 8 weeks after the treatment, while the control group received 4 weeks of local injection therapy. The incidence rates of adverse reactions (which included gastrointestinal reactions, liver function damage, and anaphylaxis),the sputum negative conversion rate at end of the second month, the incidence rate of tracheal stenosis and the decline rate of pulmonary function in the two groups were observed and compared. Results There was no significant difference in the rate of gastrointestinal reaction, liver function damage and anaphylaxis in the two groups (P>0.05). The sputum negative conversion rate at end of the second month in the observation group was significantly higher than that in the control group (P<0.05), and the incidence of tracheal stenosis and the decline rate of pulmonary function were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion Systemic chemotherapy combined with local injection by bronchoscope for 8 weeks was more effective than local injection for 4 weeks and with fewer complications in the treatment of tracheobronchial tuberculosis and it is worth recommending to use in clinical work.