Background:A flexible bronchoscopy is an essential tool that is globally used for the diagnosis and treatment of Broncho-pulmonary diseases. However the indication and outcome of flexible bronchoscopy has not been widely documented in majority of low resource settings. Objective:To determine the indications and outcome of flexible bronchoscopy (FB) at Muhimbili National Hospital (MNH). Methodology: A cross sectional analytical study was conducted for a period of 12months. Details involving indications and outcome of flexible bronchoscopy includes; bronchoscopy findings, therapeutic value, diagnostic yield, and early procedural related complications together with their demographic data were documented after each procedure followed by analysis using SPSS version 25. Results:Among 151 patients underwent flexible bronchoscopy 76(50.3%) were male and 75(49.7%) were female. The median age of 58 years with IQR (43, 65). Among the indications of flexible bronchoscopy, Cough and hemoptysis were the leading by 82.1% and 25.2% respectively. On the other hand hyperemic mucosa (31.1%) and endobronchial mass (21.2%) constituted the majority of the bronchoscopy findings. The overall diagnostic yield was 34.3% and procedural related complications was 18.54%. Among the indications for flexible bronchoscopy, the hemoptysis was associated with procedure related complications by 31.6% (p-value<0.020, OR 2.779). Among sampling technique of flexible bronchoscopy, the endobronchial biopsy and BAL sampling technique were associated with procedure related complications by 39.5 %( p-value<0.001, OR 4.393) and 14.7 %( p-value<0.005, OR 1.870) respectively Conclusion: We have demonstrated that flexible bronchoscopy is a safe and reliable procedure in diagnosis of respiratory maladies including MTB at Muhimbili National Hospital.