Bronchoscopy plays an indispensable role in lung transplantation. It is an essential part of the evaluation of potential lung donors, and it is the pivotal procedure in the management of lung transplant recipients. Although advances in immunodiagnostic methods may ultimately lead to noninvasive tests to detect rejection, histology will be the standard for some time, and transbronchial biopsy will remain the procedure of choice. Furthermore, the usefulness of bronchoscopy in the diagnosis of pulmonary infection after lung transplantation is unlikely to be supplanted by any emerging technique.