Aortobronchial fistula is an extremely rare cause of hemoptysis. Aortobronchial fistula occurs in patients who have a history of thoracic vascular surgery. Because its symptoms are nonspecific, a high index of suspicion is critical if the physician is to detect it. The results of imaging studies (e.g., plain films, computed tomography, and angiography) and bronchoscopy are sometimes, but not always, diagnostic—another reason the diagnosis is difficult. Left untreated, mortality in patients with aortobronchial fistula is 100%. Patients can be salvaged by a variety of techniques, including the placement of an endovascular stent. We describe the case of a 52-year-old man who came to us with hoarseness and hemoptysis, which proved to be underlying symptoms of aortobronchial fistula. He was treated successfully.