Objective: To investigate the role of ultrasound in the differential diagnosis of Kikuchi disease (KD) and tuberculous lymphadenopathy (TLPN). Methods: An analysis included 75 cases of KD and 215 cases of TLPN with their grayscale and color doppler flow features was performed retrospectively. Results: Both KD and TLPN had yong female predominance,and mostly occurred at the neck area. On sonography KD had homogeneous appearances with intact and sharp capsules and clear hilum. The cortex in KD was homogeneous hypoechoic. The distribution of blood was hilum pattern and flow density had a predominance of grade Ⅱ~Ⅲ. In TLPN,peri-nodal edema was shown. And in most diseased nodes,the hilum disappeared,the nodes usually fused to form a mass,the capsule was thickened or even disappeared. Liquifications and calcifications were common findings in TLPN. The distribution of blood revealed peripheral type or bloodless type and flow density were mainly grade 0 ~Ⅰ. The resistive index(RI) was higher in TLPN(P < 0.001). Conclusion: The sonography apperances are distingishable between KD and TLPN of superficial lymph nodes and will supply as indications for biopsy.