Introduction: Various methods are reported for diagnosis of exercise-induced pulmonary haemorrhage (EIPH). Cytological evaluation of airway samples is a sensitive method, but the correlation between tracheal wash (TW) and bronchoalveolar lavage fluid (BALF) findings for diagnosis of EIPH is unknown. The objective was to determine whether diagnosis of EIPH, using haemosiderophages/macrophages (H/M) ratio, differs when based on samples from TW and BALF collected concomitantly from the same racehorse. Methods: Prospective cross-sectional study on 102 Standardbred horses in active training. TW and BALF from each lung separately were collected from all horses at rest. Smears were stained with May-Grünwald-Giemsa (MGG) and H/M ratio calculated. Diagnostic cut-off values were set at 17% for individual (left and right) BALF and 9% for pooled BALF. H/M ratio in TW samples were scored as none (0%), occasional (<10%), small (10-25%), moderate (25-50%) or large proportions (>50%). Results: In BALF, 21 horses met the cytological inclusion criteria for EIPH diagnosis from individual and/or pooled samples. In TW, 20 horses had occasional proportions of haemosiderophages, and respectively 9, 1 and 3 horses had small, moderate and large proportions. Poor correlations between TW and respectively pooled, left and right BALF were found for H/M ratio. Among the 13 horses with at least small proportions of haemosiderophages in TW, 8 (61.5%) had no cytological evidence of EIPH in any BALF. Conclusion and clinical relevance: No association between TW and BALF was found for the cytological diagnosis of EIPH. A large number of horses has cytological evidence of pulmonary bleeding in BALF with none or occasional proportions of haemosiderophages in TW. In addition, finding small to large proportions of haemosiderophages in TW is mostly not associated with evidence of pulmonary haemorrhage in BALF. Based on H/M ratio, BALF remains the sample of choice for cytological diagnosis of EIPH.