The aim of this study was to study clinical and radiological aspects of caseous pneumonia in Burkina Faso where we have higher prevalence of tuberculosis/HIV. 3 years of retrospective study, from 1st January to December 31-1999, had been carried out in the "Centre Hospitalier National Yalgado Ouédraogo de Ouagadougou". Among 106 of patients studied, 26 caseous pneumonia were observed (24.5%) of whom 9 patients were holders of HIV. Often observe on late because of the non specificity of signs, 9 cases of pneumonia upon 26 were excaved (2 holders of HIV and 7 non holders of HIV). The lesion have predominated on upper right lob (19 cases upon 26). The antituberculosis treatment was effective in the major cases but with the sequella (excavations, fibrosis) in patients with excaved lesions or treated in late. Considering the gravity of the disease and its sequella which can be avoid, the presence of fever, slimming even at absence of bacteriologic prouf in debilited patient must evoke caseous pneumonia diagnosis and allowed to begin specific treatment.