Purpose : This study was performed to identify the characteristic findings of miliary pulmonary tuberculosison HRCT and to evaluate the usefulness of HRCT to compare with chest radiographs. Material and Methods : Highresolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliarypulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glassdensity, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared withchest radiographic findings. Results : On HRCT, characteristic 1-2mm sized sharp or ill-defined nodular densitieswere randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhatlarge and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in threecases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the marginof nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion(n=5), pleuraleffusion(n=4), mediastinal lymphadenopathy (n=6) and ARDS(n=1) were also associated. Conclusion : HRCT couldsuggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings inappropriate clinical setting and normal or interstitial pattern of chest radiographs.