When life-threatening hemoptysis occurs, it can be challenging to treat. We present a case of a 61-year-old female with massive hemoptysis treated with multiple doses of nebulized tranexamic acid (TXA). This treatment led to the resolution of respiratory distress and the improvement of hemoptysis. Ultimately, in cases of massive hemoptysis, repeated treatments with nebulized TXA may be a safe short-term option for symptom management prior to a more definitive therapy via bronchoscopy or bronchial arterial embolization.