Flexible fiberoptic bronchoscopy is generally a well-tolerated procedure with few adverse effects. We report a patient with catastrophic asthma attack after bronchoscopy. Chest radiography showed peri-hilar pulmonary infiltrates. An electrocardiogram demonstrated sinus rhythm. Negative pressure pulmonary edema (NPPE) was highly suspected. Unexpected lidocaine-associated bronchospasm and pulmonary infiltrates are unusual clinical manifestations.