Background. As an extremely rare entity reported in children, Rasmussen`s aneurysm is an inflammatory pseudo-aneurysmal dilatation of a branch of the pulmonary artery adjacent to or within a tuberculous cavity.

Case. Here, we reported a 9-year-old child with Down syndrome who presented with massive hemoptysis. Endovascular coil embolization was performed for Rasmussen`s aneurysm. During the 2-year follow-up period, she had no further episodes of bleeding.

Conclusions. In case of the development of massive hemoptysis in the follow-up of a patient with pulmonary tuberculosis and Down syndrome, this lethal complication should be considered.

Keywords: Down syndrome, child, rasmussen`s aneurysm, tuberculosis