We describe a patient with ulcerative colitis (UC) and the rare extraintestinal manifestation of fulminant tracheobronchitis. A 50-year-old man presented with respiratory compromise and bloody diarrhea. His evaluation showed large airway inflammation with fibrinopurulent debris and colonic inflammation and ulcerations consistent with UC. The etiology for the pulmonary pathology was thoroughly investigated and was thought to be an extraintestinal manifestation of the UC.