Background and study aim: Tuberculosis (TB) is a huge public concern in Sudan. According to the world health organization (WHO), Sudan alone carries 15% of the TB burden in the Eastern Mediterranean Region. This study was designed with the aim to evaluate the clinical value of sonography in the diagnosis and determine the effects of TB in the urinary tract (kidneys, ureters and urinary bladder) of infected and untreated Sudanese subjects. Patients and Methods: This prospective study was conducted at Al-Nihood Teaching Hospital in West Kurdufan State- Sudan. It spanned a period of 4 years from January 2008 to January 2012, involving 200 untreated Sudanese patients (118; 59% males and 82; 41% females) and aged 1 to 85 years; mean age of 37 ± 2.9 years. Samples proved to have TB either by one urine culture positive for Mycobacterium TB, or a histopathological confirmation of caseating necrotic lesions in a biopsy or surgery specimen. Sonography was performed using Toshiba Just Vision 200 and Tokimec CS-2020 fitted with 3.5 MHz convex transducers. Results: In TB patients, ultrasound findings in kidneys were varied and included wide spectrum of abnormalities like renal stones (24%), hydronephrosis (17%), renal cavitations (8%), renal cyst (16%), Pyelonephritis (12%), parenchymal renal disease (9%), renal abscess (3%), atrophied kidneys (5%), renal solid mass, end stage kidney disease and non visualized kidneys (2%). Findings in ureters include hydroureter (8%) and in urinary bladder (UB) ultrasound detected UB wall thickening (12.5%), vesicle stone (1%) and UB mass (0.5%). Conclusion: Urinary tract sonography is a quick and non invasive method of evaluating the urinary tract in miliary TB conditions. Therefore, after proven TB infection either by urine culture or histological confirmation, ultrasound can used widely to determine its effects in urinary tract and to monitor the therapeutic efficacy in a clinical situation.