PURPOSE: To evaluate the clinical and radiological characteristics of tuberculous pneumonia (TBPn). MATERIALS AND METHODS: We compared the clinical presentation, pneumonia severity index (PSI), and radiological findings of 51 TBPn patients with those of typical pulmonary tuberculosis (PulTB) and community-acquired pneumonia (CAP) patients. RESULTS: The mean age of patients with TBPn was higher than that of patients with CAP or PulTB (66.6 +/- 15.8 vs. 53.1 +/- 17.1, 54.9 +/- 15.7) (p < 0.05). Diabetes mellitus was more common in patients with TB than in those with CAP (24.1% vs. 8.2%) (p < 0.05). The PSI scores for TBPn and CAP were similar (79.5 +/- 31.1 vs. 71.8 +/- 28.3, respectively) and were higher than that for PulTB (64 +/- 26.8) (p < 0.05). The ratio of lower lobe involvement was higher in TBPn and CAP than in PulTB (49% and 75.5% vs. 22.4%, respectively). Cavity formation and centrilobular nodules were more common in TBPn than in CAP (13.7% vs. 6.1% and 74.5% vs. 22.4%, respectively) (p < 0.05). CONCLUSION: Although TBPn shows a similar clinical presentation to CAP, it is more common in elderly patients and more commonly involves lower lobe involvement with cavity formation and centrilobular nodules. Therefore, in cases in which there may be diagnostic uncertainty, appropriate diagnostic procedures following these findings are required to differentiate these diseases.