Real-time ultrasound-guided needle aspiration technique through the airway (endobronchial ultrasound-guided transbronchial needle aspiration; EBUS-TBNA) or esophagus (endoscopic ultrasound-guided fine needle aspiration; EUS-FNA) has been reported to be an accurate and minimally invasive technique for evaluation of hilar/ mediastinal lesions. Both techniques have been reported to be complementary because some accessible regions differ from each other. However, the combination of these procedures, which require separate equipment or examiners, is much more complex than either procedure by itself. The mechanism of EBUS bronchoscopes is similar to that of EUS endoscopes, and so bronchoscopic transesophageal ultrasound–guided fine needle aspiration (EUS-B-FNA) is feasible. The combination of EBUS-TBNA and EUS-B-FNA in place of conventional EUS-FNA is an accurate and simple technique for mediastinal staging of lung cancer, which can be performed by a pulmonologist using an EBUS bronchoscope in one session. Individual pulmonologists should be trained in both EBUS-TBNA and EUS-B-FNA.