Endovascular embolization has become an established procedure for the management of massive or recurrent hemoptysis. The bronchial, nonbronchial systemic and pulmonary arteries are possible sources of bleeding, and the major sources of bleeding are the bronchial arteries (BAs). However, the locations of ostia of the BAs have numerous anatomical variations, which can make it technically challenging to identify a bleeding artery. We herein present a rare case of a left BA that originated from the ipsilateral vertebral artery in a patient with massive hemoptysis caused by active tuberculosis. Transarterial embolization was successfully performed, and the hemoptysis has been controlled for 2 months.