It is not difficult to diagnose female genital tuberculosis. The possibility of genital tuberculosis should be considered first based on the patient’s infertility, scanty or amenorrheic menstruation, unmarried with hypothermia and wasting, chronic pelvic inflammatory disease that has been untreated for a long time, history of exposure to tuberculosis or history of tuberculosis in herself, especially if she has pulmonary tuberculosis, pleural tuberculosis, followed by tuberculous peritonitis, erythema nodosum and renal and bone tuberculosis. Careful inquiry about the history of tuberculosis and chest X-ray examination should be performed. If genital tuberculosis is suspected and there are no clear signs, the diagnosis must be clarified by endometrial pathology or bacteriological examination, hysterosalpingography and other auxiliary diagnostic methods. Some patients with genital tuberculosis have a long history of chronic wasting, poor appetite, wasting, easy fatigue, persistent afternoon fever or menstrual fever, irregular menstruation, and chronic lower abdominal pain. The diagnosis of adnexal tuberculosis is almost always made in young girls with inflammatory adnexal masses. For adnexal inflammatory masses with no obvious history of infection, a slow course of disease and poor general treatment results should be considered tuberculous. The following common gynecologic diseases have signs very similar to those of internal genital tuberculosis and often need to be identified clinically. 1, chronic non-specific adnexitis and chronic pelvic inflammatory disease: patients are also often infertile, pelvic signs and internal genital tuberculosis is very similar, but the former more often have a history of childbirth, abortion and acute pelvic inflammatory disease; menstrual volume is generally high, rarely amenorrhea; when chronic adnexitis is not cured, hysterosalpingography or scraping can be done to exclude genital tuberculosis. 2, endometriosis: endometriosis of the ovaries has more similarities with the clinical manifestations of genital tuberculosis. For example, infertility, low fever, abnormal menstruation, lower abdominal cramps, formation of pressure and fixed masses in the pelvis, etc. However, patients with endometriosis often have progressive dysmenorrhea, and one to two or more small hard nodules are often palpable in the rectal fossa, uterosacral ligament, or posterior wall of the cervix. In the absence of the above two clinical manifestations, laparoscopic examination can be performed to clarify the diagnosis when there is difficulty in diagnosis. 3. Ovarian tumor: tuberculous encapsulated effusion can sometimes be misdiagnosed as ovarian cystic species or ovarian cystic adenoma. It can be easily identified by medical history, clinical symptoms, and physical signs such as tuberculous adnexal masses with unsmooth and inactive surface and fibrous adhesion thickening around. Patients with advanced ovarian cancer often have cachexia, fever, accelerated blood sedimentation, and metastatic lesions in the pelvic floor in addition to adnexal masses, which are not easily distinguished from pelvic tuberculosis combined with tuberculous masses of fallopian tubes and ovaries. Fine needle aspiration can be performed under B-ultrasound guidance to find antacid bacteria and cancer cells. If it is inaccessible, laparoscopy or dissection should be performed according to the situation to clarify the diagnosis early and seek appropriate treatment to save the patient’s life.