We present 2 patients with pulmonary aspergilloma complicated by massive hemoptysis who were not good candidates for surgery and were treated with intracavitary amphotericin B after arterial embolization failed. In spite of the size of the mycetomas, response to treatment was excellent with full regression of the aspergilloma after 3 to 4 weeks; precipitins to Aspergillus fumigatus became negative and the fungus disappeared from transcatheter aspirate samples. Massive hemoptysis was controlled with epsilon-amino-caproic acid instilled by catheter. No complications were observed, the treatment was well tolerated and no recurrence occurred over a follow-up period of 24 and 18 months, respectively. This local treatment is the best therapeutic alternative for patients with pulmonary aspergilloma who are not candidates for surgery.