The diagnosis of tuberculosis depends on the culture of Mycobacterium tuberculosis from the patient’s secretory body tissues, as well as on the presence of certain clinical manifestations. The form of onset of the disease and its signs and symptoms vary widely, but the typical ones are predominant. Many patients lack signs and symptoms, and non-specific manifestations may include fever, anemia, decreased signs or joint pain. It is important to recognize the possibility of tuberculosis in acute and chronic diseases of almost organs. Diagnosis of tuberculosis, smear and culture examination of sputum provides the basis for diagnosis in most patients with tuberculosis. Specimens of sputum are best if coughed up from morning. Patients are first smear sputum examined 3 times, and the results of the pattern determine the number of sputum cultures. 3 smear examinations with more than 2 positive results are sufficient for 3 sputum cultures. If 3 times all negative or only once positive, sputum culture should be done more times. Patients with negative sputum culture tend to discharge bacteria intermittently, and the amount of bacteria excreted is small. Therefore, increasing the number of cultures can increase the chance of positivity. In patients with high suspicion of tuberculosis and negative sputum smear, sputum culture should be examined 6 to 10 times. The sputum culture specimen should be taken before chemotherapy because the sputum smear negative patient has little bacterium excretion and the culture result can be affected by chemotherapy slightly. When the patient coughs or does not cooperate, other methods can be used to help obtain sputum, such as gastric lavage before the patient wakes up or when awake before eating, hot saline inhalation to induce coughing, and the laryngeal test method. Specimens may be obtained by transtracheal puncture aspiration. Many patients also cough as a result, and sputum specimens are obtained. This method is suitable for semi-conscious patients, although it is not very safe, with serious complications and some adverse consequences. Therefore, the indications should be strictly selected, the growth period of Mycobacterium tuberculosis takes 3 to 8 weeks, which makes it impossible to wait for positive culture results before starting chemotherapy, early treatment must rely on X-ray and sputum smear examination, and early smear antacid bacilli as a good method of diagnosing tuberculosis. The typical x-ray presentation of secondary tuberculosis is easy to recognize, mostly showing infiltrative lesions with or without occurrence in the tip of the upper lobe, cavities in the posterior end, and less common involvement of the tip of the lower lobe, but chronic lesions occurring in this area should be more suspected and tuberculous possible. Parenchymal infiltration due to tuberculosis can occur in isolation in the lower and middle lobes and is particularly common in elderly patients. Such patients sometimes have endobronchial lesions, and the presence of eosinophilic caseous granulomas can be confirmed by bronchial biopsy. There are several other points that may help in the diagnosis. Alcoholics, bronchial lung cancer, diabetes mellitus, silicosis, and immune deficiency due to dermatomycin therapy are often prone to complications of tuberculosis. A comparison of previous and current chest films is performed to observe the detection of lesions, and based on these alone, the diagnosis can be made even in patients with negative bacteriology and lack of symptoms. Under certain conditions, the diagnosis of TB can be established in time with negative bacteriology. Chest radiographs show lesions consistent with tuberculosis, i.e. one or more small, non-cavitary lesions, and the patient has a positive tuberculosis test, and other diagnoses can be ruled out. This condition is diagnosed as tuberculosis. The other situation is in young or elderly people with a history of exposure who have X-rays showing progressive lesions. It is emphasized that there are half of patients with cavitary TB who have negative sputum smears, but negative cultures are less common.