If the patient does not have sputum, other tests can be combined to assist in the diagnosis of TB, such as CT chest examination, which is very important to understand whether there are polymorphic changes in the chest such as plaques, exudates, nodules, proliferation, calcification, cavity formation, and fibrous cords. If these changes are present clinically with symptoms such as cough, blood in sputum, hot flashes and night sweats, the diagnosis of TB can also be considered. Other tests including tuberculin test, T-cell test for TB infection and fiberoptic bronchoscopic alveolar lavage fluid examination can assist in the diagnosis of TB. In conclusion, the diagnosis of pulmonary tuberculosis without sputum can be combined with clinical symptoms, chest imaging and other comprehensive examination means to assist in the diagnosis, and diagnostic anti-tuberculosis treatment can be given if necessary to avoid greater infectiousness due to missed diagnosis and misdiagnosis.