Bronchial artery–pulmonary artery arterio–venous malformation, previously known as “bronchial artery primary racemose hemangioma” is a rare vascular malformation. The literature surrounding the imaging findings and treatment is currently limited. We hereby describe the imaging findings and a novel endovascular approach of utilizing bi-directional embolization from both the pulmonary and bronchial artery to occlude the malformation, leading to thrombosis and resolution of symptoms. This strategy represents a potential treatment option of non-surgical patients in this rare malformation.