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Sputum, or phlegm, is a mixture of saliva and mucus that you’ve coughed up. Blood-tinged sputum occurs when the sputum has visible streaks of blood in it. The blood comes from somewhere along the respiratory tract inside your body. The respiratory tract includes the:

  • mouth
  • throat
  • nose
  • lungs
  • passageways leading to the lungs

Sometimes blood-tinged sputum is a symptom of a serious medical condition. However, blood-tinged sputum is a relatively common occurrence and typically isn’t cause for immediate concern.

If you’re coughing up blood with little or no sputum, you should seek immediate medical attention.

Common causes of blood-tinged sputum include:

More serious causes of blood-tinged sputum can include:

Lower respiratory infections and inhaling a foreign object are the likely causes of blood-tinged sputum in children.

You should call your doctor right away if you experience any of these symptoms:

  • coughing up mostly blood, with very little sputum
  • shortness of breath or struggling to breathe
  • weakness
  • dizziness
  • sweating
  • rapid heart rate
  • unexplained weight loss
  • fatigue
  • chest pain
  • blood also in your urine or stool

These symptoms are associated with serious medical conditions.

When you see your doctor to diagnose the reason behind the blood-tinged sputum, they’ll first ask you if there was any noticeable cause such as:

They will also want to know:

  • how long you’ve had blood-tinged sputum
  • how the sputum looks
  • how many times you cough it up in the day
  • the amount of blood in the phlegm

Your doctor will listen to your lungs while you breathe and may look for other symptoms of concern, like a rapid heart rate, wheezing, or crackles. They’ll also ask you about your medical history.

Your doctor may also run one or more of these imaging studies or procedures to help them reach a diagnosis:

  • They can use chest X-rays to diagnose a variety of different conditions. This is often one of the first imaging studies they order.
  • They can order a chest CT scan to provide a clearer image of soft tissues for evaluation.
  • During a bronchoscopy, your doctor looks into your airways to check for obstructions or abnormalities by lowering a bronchoscope down the back of the throat and into the bronchi.
  • They can order blood tests to diagnose different conditions, as well as determine how thin your blood is and check to see if you’ve lost so much blood that you have anemia.
  • If your doctor notices a structural abnormality in your lungs, they may order a biopsy. This involves removing a sample of tissue from your lungs and sending it to a lab for evaluation.

Treating blood-tinged sputum will rely on treating the underlying condition causing it. In some cases, treatment can also involve reducing inflammation or other related symptoms you’re experiencing.

Treatments for blood-tinged sputum can include:

  • oral antibiotics for infections like bacterial pneumonia
  • antivirals, such as oseltamivir (Tamiflu), to reduce the duration or severity of a viral infection
  • [affiliate link:] cough suppressants for a prolonged cough
  • drinking more water, which can help flush out remaining phlegm
  • surgery to treat a tumor or blood clot

For people who are coughing up large amounts of blood, treatment first focuses on stopping the bleeding, preventing aspiration, which occurs when foreign material gets into your lungs, and then treating the underlying cause.

Call your doctor before using any cough suppressants, even if you know the underlying cause of your symptoms. Cough suppressants can lead to airway obstructions or keep the sputum trapped in your lungs, prolonging or worsening an infection.

Blood-tinged sputum can sometimes be a symptom of an underlying condition that’s unavoidable, but methods are available to help prevent some cases of it. The first line of prevention is to take steps to avoid the respiratory infections most likely to bring on this symptom.

You can do the following to prevent blood-tinged sputum:

  • Stop smoking if you smoke. Smoking causes irritation and inflammation, and also increases the likelihood of serious medical conditions.
  • If you feel a respiratory infection coming on, drink more water. Drinking water can thin out phlegm and help flush it out.
  • Keep your house clean because dust is easy to breathe in, and it can irritate your lungs and make your symptoms worse if you have COPD, asthma, or a lung infection. Mold and mildew can also cause respiratory infections and irritation, which can lead to blood-tinged sputum.
  • Coughing up yellow and green phlegm may be a sign of a respiratory infection. See your doctor for treatment early on to help prevent complications or worsening of symptoms later.