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Introduction and Objectives Concerns about bleeding complications, driven by the vascular nature of some bronchopulmonary carcinoid tumours (BPCs) and previous data, can lead to hesitation in performing bronchoscopic biopsies in some secondary care settings. We retrospectively reviewed our tertiary centre experience over a 13-year period to determine the safety profile of bronchoscopic sampling in BPCs.Methods A retrospective review of patients with BPCs undergoing diagnostic bronchoscopic biopsy between 2009–2021 was conducted using electronic patient records from a large tertiary referral bronchoscopy unit. Bronchoscopy reports were reviewed to determine complications across three diagnostic bronchoscopic procedures: standard flexible bronchoscopy, navigational bronchoscopy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Patients undergoing rigid bronchoscopy or bronchoscopy under general anaesthetic were excluded. Bleeding severity was classified based on the British Thoracic Society bronchoscopy guidelines.Results The study included 59 patients (62.7% female) with a mean age of 57.6 years. Most had a performance status of 0 (57.6%) or 1 (33.8%) at diagnosis. Typical carcinoids were most commonly diagnosed (74.5%), followed by carcinoid not otherwise specified (15.2%). The primary tumour was predominantly right-sided (66.1%), most frequently affecting the right lower lobe (27.1%). The mean tumour size was 28.8 mm (IQR: 6–75 mm). There were no reports of severe bleeding (0%). Bleeding was most commonly reported as mild (16.9%) or moderate (11.8%), (see table 1), all safely managed with cold saline (n=11) or adrenaline (n=7) as necessary. The incidence was similar across all bronchoscopic procedures. Pre-biopsy interventions included topical adrenaline (27.1%) and cold saline wash (8.4%). Post-procedure, two patients (3.3%) reported chest discomfort within 48 hours, but chest X-rays in both showed no pneumothorax. No patients required blood transfusion, fluid resuscitation, acute admission or any management beyond standard bronchoscopy care.Abstract P209 Table 1Bleeding complications across all bronchoscopic procedures, pre- and post-biopsy interventions, immediate postoperative complications, and subsequent management interventions used in 59 patients identified in this studyConclusions Our findings demonstrate bronchoscopic sampling of PBCs is safe with no evidence of severe bleeding across all bronchoscopic procedures, challenging the perceived need for tertiary referral for sampling. Careful reconsideration of current referral pathways could streamline care by expediting diagnosis locally, without compromising safety, whilst also alleviating pressure on tertiary services.