Background: Thoracic endometriosis syndrome (TES) is a rare disease in which a functioning endometrial tissue is observed in the pleura, lung parenchyma, airways, or diaphragm. The optimal management of this disease remains a matter of debate Methods: Retrospective study in one university based tertiary care hospital between 1997 to 2017. 14 women presented as CH diagnosed with thoracic endometriosis were included. The main outcome of measure was cessation or recurrence of the clinical manifestations of thoracic endometriosis. Baseline parameters were presented using descriptive statistics. For categorical variables, Pearson’s chi-square tests or Fisher’s exact tests was used as appropriate to describe the characteristic of thoracic endometriosis presented as CH, and the long-term prognosis after hormonal treatment. Results : The mean onset age of the 14 patients was 30.21±5.40 years. Catamenial hemoptysis (CH) was characteristic symptom of these patients, and most of patients (13/14, 92.9%) had regular menstruation and only 42.9% (6/14) of the patients complained of different degrees of dysmenorrhea. All patients underwent chest computed tomography (CT) scan during menstruation and 2 or 3 weeks after menstruation, which showed the obvious shrinking or disappearance of the lesions. No active bleeding on bronchial mucosa were observed in patients with CH, and the bronchoalveolar lavage (BAL) did not find the typical abnormality. All of patients were given GnRH-a for 3 to 6 months, eleven of them were administered with COCs cyclically after GnRH-a. All patients were followed up and the median follow-up duration was 24 months. Hemoptysis recurrence was observed in one patient. Conclusion: CH is a rare clinical entity of thoracic endometriosis, which has the typical cyclic manifestation with menstruation. The change of CT images during and after menstruation or the response to GnRHa were helpful for accurate diagnosis. Hormonal treatment with GnRH-a followed by COCs cyclically could be employed as a choice of therapy for efficient management of thoracic endometriosis.