Nowadays, the acquired immune deficiency syndrome (AIDS) is most certainly the major cause of the increased incidence of tuberculosis (TBC). A total of 138 patients (pts) with AIDS were referred to the Department of Infectious Diseases of the Hospital of Pisa, 1990-1991; 14 of them (10.1%) presented pulmonary TBC. In our study, we analyzed the chest films of the latter group of patients. Based on the X-ray patterns, the findings were classified as follows: hilar lymph nodes were observed in 4 pts (28.6%), isolated lymph nodes in 2 cases; associated with parenchymal involvement in 2 pts; acute alveolar TBC was seen in 4 cases (28.6%), with escavations in 3/4 (21.4%). Linear and reticular TBC were found in 4 pts (28.6%), and miliary interstitial involvement in 1 case (7%), extrapulmonary adenopathy in 4 pts (28.6%). In 4 pts (28.6%) chest X-ray findings were negative. All pts underwent serial chest X-rays in the course of therapy. HRCT was performed in 6 patients: our results are in agreement with those reported in literature. Thus, we can conclude that the major diagnostic findings in our series were: frequent isolated involvement of hilar lymph nodes, as observed in primary TBC; the infiltrates are most frequently located in the middle and basal lobes; escavations are uncommon; pleural effusion is unusual; in some pts chest X-ray findings may be negative.