Pathological examination of tuberculosis sequelae was carried out to clarify the nature and pathogenesis of sequela. Twenty-one cases were chosen from autopsied cases in the past 15 years; male 20, female 1, and age ranged from 43 to 78 and mean age was 59 years. Sequela cases were divided into two subgroups; low lung function subgroup (LLFS) and non-low lung function subgroup (NLLFS). LLFS had 10 cases and mean age was 55 years. Ten cases of bilateral fibrotic cavities, 10 cases of bilateral upper lobe atelectatic indurations, 4 cases of pneumonectomy, 4 cases of thoracoplasty, and others were basic lesions of sequela. Lobar atelectatic induration was formed of organized destructive pneumonia and suspected to follow the tuberculous granulomatous pneumonia. Seven cases of localized emphysema, 11 cases of bullae were seen as the secondary change. Mean heart weight was 335 gr and left ventricle + septum: right ventricle (LV+S: RV) ratio decreased to 1.24 among LLFS and mean heart weight 273 gr and Lv+S: RV ratio was 2.35 in NLLFS. Remaining of cavities were observed in 15 cases and Aspergillus infection was seen in 11 cases (7 cases formed fungus ball, 4 cases showed semi-invasive growth and 2 out of 4 showed necrotizing pneumonia and formed direct cause of the death). Terminal infection was seen in 10 cases. According to our data, chronic lung failure with cor pulmonale, secondary fungus infection in the remained cavity, and terminal infectious pneumonia were serious consequence of tuberculosis sequela.