Clinically, multiple sites of TB are very common and it is not uncommon for more than two sites of TB lesions to require surgical treatment, especially in specialized TB hospitals. The more common types of lesions include bilateral tuberculous abscesses, tuberculous destroyed lung or tuberculous abscesses combined with thoracic spine tuberculosis, tuberculous abscesses combined with subdiaphragmatic or perihepatic abscesses, pulmonary or bone tuberculosis combined with cervical lymphatic tuberculosis, multiple chest wall or abdominal wall tuberculosis, and lumbar spine tuberculosis combined with renal and ureteral tuberculosis. The indications for surgery and the timing and methods of surgery for these patients are different from those for single-site TB because of the combination of different sites of TB. The selection of surgical treatment plan for multiple-site tuberculosis 1. If two or more sites of tuberculosis are indicated for surgery, the patient’s nutritional and immune status, cardiopulmonary function, site of lesion, intended surgical approach, surgical access, and impact on organ function should be evaluated to determine whether simultaneous or staged surgery is indicated. If possible, simultaneous surgery should be performed when the patient is assessed to be able to safely tolerate surgery. The advantages are: (1) better compliance with treatment. Patients with tuberculosis requiring surgical intervention often experience months or even years or even decades of pain and suffering, and their physical and mental capacities are poor. (2) The cost of treatment can be greatly reduced compared to staged surgery. (3) Shorten the length of hospital stay. (4) A well-designed multiple-access surgical approach does not carry an increased risk of perioperative-related complications. (5) Simultaneous removal of major active tuberculosis lesions can substantially reduce the patient’s infection and inflammatory load, which will better improve the patient’s systemic nutritional and immune status and facilitate the implementation of drug therapy. In clinical practice, there is no significant difference in the number of days of hospitalization between patients who undergo simultaneous surgery at multiple sites and those who undergo surgery at a single site. Factors that make simultaneous surgery inappropriate include: (1) The course and regression of tuberculosis lesions at different sites may not be synchronized, and the timing of surgery may not be synchronized. For example, if lung lobe destruction has existed for several years, combined with newly emerged thoracic spine tuberculosis, or if thoracic spine tuberculosis is combined with abscess chest, each lesion should be treated separately according to the respective indications for surgery. (2) For lesions located in the bilateral thoracic cavity or lungs, bilateral pleurofibrillar debridement or lobectomy is not recommended because simultaneous surgery may result in severe postoperative respiratory depression. (3) Fewer physicians have experience in multidisciplinary surgical treatment, and often require the cooperation of multidisciplinary physicians such as thoracic surgery, orthopedic surgery, and genitourinary surgery to perform the surgery in stages.