The study evaluated the safety and efficacy of combining endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with transbronchial cryobiopsy (EBUS-TBCB) or transbronchial forceps biopsy (EBUS-TBFB) in the diagnosis of intrathoracic lymphadenopathy. 211 patients with mediastinal or hilar lymph nodes ≥ 1 cm in size and abnormal PET-CT activity were included in the retrospective analysis. The diagnostic sensitivity of the combined methods reached 96.92%, the specificity 100% and the overall accuracy was high. There was no significant difference in the diagnostic yield when comparing EBUS-TBNA with EBUS-TBCB and EBUS-TBNA with EBUS-TBFB, but for pulmonary sarcoidosis, the diagnostic rate was higher when combined with EBUS-TBCB (96.67% vs. 87.50%). The most common complication was mild hemoptysis in 4.74% of patients, with no major adverse events such as major bleeding or infections. The method is safe and minimally invasive, allows obtaining a sufficient amount of tissue for molecular testing and accurate diagnosis of both benign and malignant diseases.