Tuberculosis has troubled humankind throughout history, It has been a leading cause of death throughout the world, and still is in low-income and middle-income countries, especially those of sub-Saharan Africa where tuberculosis is an epidemic because of the increased susceptibility conferred by HIV infection. Tuberculosis defined as chronic necrotizing bacterial infection which is a specific disease caused by infection with Mycobacterium tuberculosis, the tubercle bacillus, which can affect almost any tissue or organ of the body, the most common site of the disease being the lungs (Pulmonary) and extrapulmonary TBEPTB) is more commonly encountered in clinical practice. Primary TB is typically a mild or a symptomatic localpulmonary infection. Tuberculosis (TB) is a global burden and infection with human immunodeficiency virus is a growing epidemic. Prompt diagnosis and treatment can lead to control of tuberculosis in the world. A total of nine million new cases and approximately two million deaths from TB were reported in 2004. The most recent estimates of the worldwide epidemic of tuberculosis are for 2004.TB pleural effusion is the second most common form of EPTB, only less frequent than lymph node TB. Diagnosis of tuberculous (TB) pleural effusions is difficult and better diagnostic tools are needed. The definitive diagnosis of TB pleural effusions depends on the demonstration of M. tuberculosis insputum, pleural fluid, or pleural biopsy specimens. Diagnosis of tuberculous pleural effusion depend on clinical manifestations, tuberculin skin reaction, chest imaging, thoracocentesis with pleural fluid analysis by (biochemical analysis, cytological analysis, microbiological and molecular studies) and depend on also invasive studies like (closed needle biopsy and medical thoracoscopy).Supportive evidence includes demonstration of classical TB granulomas in the pleura and elevated adenosine deaminase (ADA) and IFN-γ levels inpleural fluid. The first step in diagnosis is pleural fluid analysis. Immunological studies have only more recently been incorporated into the clinical diagnosis of tuberculous effusion. New diagnostic tests for diagnosis tuberculous pleural effusion founded now may helping improve Diagnosis of tuberculus effusion.