Lungcancer and pulmonary tuberculosis are two common diseases in respiratory system，which are correlated in pathogenesis. Scars，chronic inflammation and abnormal immunity in lung induced by tuberculosis increase the risk of lung cancer.The immunosuppressive status in lung cancer tumor microenvironment enhances immune evasion of Mycobacterium tuberculosis. Additionally，immunotherapy in lung cancer in fluences the development of tuberculous. Therefore，the main challenge in clinic practice is early diagnosis and therapeutics for lung cancer with pulmonary tuberculosis. Understanding the pathogenesis of lung cancer with pulmonary tuberculosis is helpful to develop new diagnostic and therapeutical methods. This article summarizes the pathogenesis，diagnosis and treatment of lung cancer with pulmonary tuberculosis for itsearly diagnosis and precision therapy.