We report an unsual case of hemoptysis, aphonia and the sensation of something in the throat observed in a 64-year-old patient, with emphysema historyand smoker, who was admitted at the department of pneumologia of EHU Oran, Algeria. After 48 hours of admission, at fibroscopy examination he was finally diagnosed with live foreign body, the patient spontaneously expelled aleech after local anesthesia by xylocaine. Hirudo medicinalis was identified byparasitological examination. A complete disappearance of symptoms and the evolution is rapidly favorable. In Algeria, leech infestation are not uncommon where 120 cases were described between 1962 and 1971 by Gerlach, so even unusual causes like leech infestation came up to be an important differential diagnosisof patient with sign of bleeding or obstruction of the upper airways a high index of suspicion is of great help to make an early diagnosis and ensure prompt treatment.