Abstract: Objective To explore the clinical value of CT-guided percutaneous lung biopsy in the diagnosis of pulmonary tuberculosis in high altitude area. Methods The clinical data of 22 cases of pulmonary tuberculosis confirmed by CT-guided percutaneous lung biopsy between October, 2016 and March, 2017 were retrospectively analyzed. Results There were 15 males and 7 females, aged 28-71 years, with an average age of (44. 7 ±14. 8) years. 11 cases complicated with the history of COPD (50%), 10 cases with high altitude heart disease (45. 5%), 9 cases with type 2 diabetes mellitus (40. 9%), and 7 cases with hypertension (31. 8%). The clinical manifestation included 7 cases of fever (31. 8%), 12 cases of cough and sputum (54. 5%), 8 cases of hemoptysis (36. 4%), 8 cases of chest pain (36. 4%), 7 cases of night sweats (31. 8%), 10 cases of loss of weight (45. 5%), 8 cases of loss of appetite (36. 4%), 9 cases without symptoms (physical examination found, 40. 9%). All the 22 patients had successful puncture, and the success rate of CT-guided percutaneous lung biopsy was 100% (22/22). The positive rate of pathologic diagnosis was 90. 90% (20/22). The positive rate of acid-fast staining for puncture fluid was 18. 2% (4/22). There was significant difference between the two groups (χ²=20. 625, P < 0. 05). A total of 5 patients with mild complication were observed. The incidence of pneumothorax was 9. 1% (2/22), pneumothorax were automatically absorbed after oxygen uptake and rest. The incidence of hemoptysis was 13. 6% (3/22), and no fatal hemoptysis occurred. Conclusion The CT-guided percutaneous lung biopsy is a safe and effective means in the diagnosis of pulmonary tuberculosis in high altitude area.