Objective: To analyze CT and X-ray manifestations of pulmonary tuberculosis of lower lung field in 45 cases and to reduce misdiagnosis. Methods: Forty-five cases of pulmonary tuberculosis of lower lung field were examined by thoracic CT and chest film. All cases were confirmed by pathology or positive tubercle bacilli. Results: Imaging manifestations of pulmonary tuberculosis of lower lung field were mainly exudative lesions (75.5%)with proliferation and fibrosis. Cavitation or global lesion was commonly associated with surrounding “”satellite lesions. Conclusion: “” Cavitation or global lesion with surrounding satellite lesions is important for the diagnosis of pulmonary tuberculosis in lower lung field. Coexistence of different kinds of lesions was a characteristic finding of the disease. The combination of imaging appearance with clinical information can reduce misdiagnosis. The final diagnosis depends on pathology or positive tubercle bacilli. CT is more sensitive than X-ray.