Updates in the management of pulmonary TB is soimportant to ensure the diagnosis and to give a high curerates from this disease, the tuberculin skin test is still usedand very helpful in diagnosing TB especially in children,more over the Quantiferon test is more effective as itdoesn't affected by BCG vaccinatin .Identification of the organism is so critical in diagnosis byzeil-neelsen stain and flourochrome stain ,cultivation ofthe bacilli is more sensitive than microscopy using eggbased (lowenstien-jensen),agar based,and liquid media,more over using the genetic probes have allowed theidentification of DNA or RNA of the mycobacteriumspecies . Serological diagnosis have not resolve yet theproblems of the sensitivity and specificity .Treatment using currently anti TB drug ( INH,RIF,PZM,EMB or STR ) in different regimens is helpfulwith high cure rates ,in addition, the flouroquinolones areused relatively to treat TB caused by drug resistant strainsincombination with clarithromycin or azithromycin andother agents. Resent pharmaceutical designs, and emergingtherapeutic targets in tuberculosis lead to new drugs thatfacilitate control the spread of tuberculosis.