Trans-Bronchial Cryo-Biopsy (TBCB) is an acceptable method for diagnosis of interstitial lung disease (ILD). Procedural bleeding is the most concerning complication. However, no data exist concerning the risk of bleeding in patients with pulmonary hypertension (PHTN). Aim and objective: We aimed to evaluate the safety of TBCB in patients with Trans-Thoracic Echocardiographic (TTE) evidence of PHTN.Method: A prospective single blinded study was conducted between 2019-2022. All patients referred to the Meir Medical Center, Pulmonary department for TBCB with suspected ILD. Patients underwent TTE on admission prior to the procedure while the pulmonologists performing the TBCB were blinded to these result. TCBC was performed under general anesthesia using the ?two scope? technique. During the procedure vital signs were monitored and bleeding was measured qualitatively (ml) and quantitatively (0-4) reflecting bleeding control measures required to achieve hemostasis.Results: Sixty patients were recruited, 13 with PHTN and 47 without. Mean age was 67±12 vs. 60±12 yrs. (p=0.17) respectively. No statistical differences were noted between the two groups in all demographic or clinical parameters. Bleeding quantity was 24±24 ml and 25±31 ml, (p=0.848) respectively. The qualitative bleeding score was 1.38±1.9 and 1.55±0.71, (p=0.609) respectively. In multivariate analysis no significant predictor was found to predict bleeding quantity. Conclusion: Mild to moderate PHTN does not pose an increased bleeding risk during TCBC. Larger trials are needed to confirm our results.