Endobronchial biopsy specimens of small-cell carcinoma often exhibit extensive crush artifact that precludes definitive diagnosis. Occasionally, cytologic study from the brushings and washings is also nondiagnostic, contributing to the frustration of the bronchoscopist. We reviewed our experience with this problem over the past 4 years. We identified five cases in which an endobronchial needle aspirate proved critical in establishing the diagnosis of small-cell carcinoma. We believe endobronchial needle aspiration is a valuable adjunct in the diagnosis of endobronchial small-cell carcinoma.