Background <p>Hypoxia is a common and potentially serious complication during general anesthesia bronchoscopy; however, the risk factors associated with its occurrence remain incompletely understood. We aimed to investigate the risk factors of hypoxia in patients undergoing general anesthesia bronchoscopy.</p> Methods <p>We retrospectively included patients who underwent general anesthesia bronchoscopy between September 2023 and February 2025 in our hospital. Hypoxia was defined as a decrease of more than 5% in baseline transcutaneous peripheral oxygen saturation (SpO₂) or an SpO₂ level below 90% during the procedure. Patients were stratified according to the occurrence of hypoxia during the procedure. Univariate and bidirectional stepwise logistic regression was performed to identify independent risk factors for hypoxia.</p> Results <p>A total of 390 patients were included, of whom 53 experienced hypoxia. Multivariate logistic analysis identified age, WBC, creatinine, mean arterial pressure (MAP), and airway stenosis as independent risk factors for hypoxia.</p> Conclusions <p>Age, elevated WBC count, increased creatinine level, higher MAP, and airway stenosis were independent risk factors for hypoxia in those underwent general anesthesia bronchoscopy.</p> Trial registration <p>Not applicable.</p>