Abstract: Bronchoscopy plays an important role in the diagnosis of pulmonary lesions, yet institutional data from regional Indonesian hospitals remain limited. This retrospective study evaluated the diagnostic performance of bronchoscopy and described the clinicopathological profile of patients who underwent the procedure at Sembiring General Hospital from January 2022 to December 2024. A total of 182 patients were included, consisting of 142 males and 40 females, with malignancy detected in 48 cases. Squamous cell carcinoma was the most frequent malignant subtype, predominantly affecting older male patients. Diagnostic yield was influenced by specimen strategy, with multimodal sampling, particularly combinations that incorporated forceps biopsy, showing higher positivity than cytology alone. Statistical analysis demonstrated a significant association between specimen combination and diagnostic outcome. Ancillary procedures such as fine needle aspiration and tumor excision provided confirmation in selected non diagnostic cases. In conclusion, multimodal sampling enhances the diagnostic value of bronchoscopy and supports its role in the evaluation of suspected pulmonary malignancy.