An 8-year-old girl was admitted to the emergency department with hemoptysis. Her history revealed that she had been drinking unfiltered tap water several days before. Physical examination revealed a black live foreign object in the pharynx with local posterior pharyngeal oozing. Pharyngeal leech was suspected and removed immediately using forceps. After removal of the leech, the bleeding stopped immediately and the patient felt comfortable. The leech was identified as belonging to the species Limnatis nilotica. Pharyngeal leeches should be included in the differential diagnosis of patients with hemoptysis, especially in patients with a history of drinking unfiltered water from sources where aquatic leeches are commonly found. Cases such as this should be considered as emergencies, and all measures should be taken to avoid hemoptysis and death.