Purpose. To study the frequency of detection of atrophic endobronchitis in the structure of general bronchological appointments; search for reference points in the visual differential diagnosis of this condition; development of tactics for the use of additional diagnostic endobronchial ma-nipulations in case of detected mucosal atrophy, depending on the specific clinical situation. Material and methods. The frequency of detection of endobronchial atrophy was assessed based on the results of 21,126 primary diagnostic and treatment bronchoscopy performed in the endoscopic room No. 2 of the hospital of Samara City Hospital No. 4 for the period 2006–2023. Bronchoscopy was carried out both in the endoscopy room and in the intensive care unit according to generally accepted indications. Results. 388 (1.837%) patients with atrophic endobronchitis were identified. The etiology of endobronchial atrophy was dominated by community-acquired pneumonia and Pneumocystis pneumonia in patients with HIV infection. Differential diagnostic criteria for atrophic endobron-chitis and changes in the mucous membrane of the tracheobronchial tree during anemia, as well as dust and nicotine impregnation of the bronchial mucosa are proposed. For the etiological verifica-tion of bronchial deformation, a special algorithm for additional diagnostic endobronchial manipu-lations in the presence of focal or diffuse endobronchial atrophy is proposed.