Abstract: Objective To explore the clinical diagnosis value of multi-slice spiral computer tomography (MSCT) on the hematogeneous disseminated tuberculosis.Methods All 37 patients including 18 males and 19 females confirmed by smear, biopsy and diagnostic treatment were collected from department of Radiology in the Second Affiliated Hospital of Xinjiang Medical University from 2013—2015. All cases were checked by chest plain film and CT scanning with MSCT.Results Among 37 patients, 13 cases showed typical signs of the acute military pulmonary tuberculosis in plain film, a lot of fine, pin-point mottling opacities, and with same size, the same dentisy and homogeneous distribution. 6 cases showed enlargement of hilar lymph nodes or mediastinal lymph nodes. 12 cases showed clumped nodular and linear areas of increased opacity nonuniform distribution.8 cases showed calcifications in the lesions.4 cases only showed lungs transparency degree reducing. Twenty-nine cases among 37 patients showed typical signs of the acute military pulmonary tuberculosis in MSCT, pin-point mottling opacities, and with same size, the same density and homogeneous distribution. 6 cases with nodular edge blur. 21 cases nodules uniform distribution, is located in the center of lobular, bronchial blood vessel bundle, interlobular septa, and subpleural.5 cases showed both lungs were studded with nodular shadows, the shadows are not uniform in size, in density and in distribution. 3 cases interlobular septal thickening and lobular reticular opacities, both lungs showed “tree-in-bud” in random distribution with edge blur. CT scanning diagnosis rate was 86.5% (32/37), X-ray diagnosis rate was 35.1% (13／37). The difference is statistically significant (χ²＝13.46,P=0.031).Conclusion MSCT has a high value for clinical diagnosis of the Hematogenous disseminated pulmonary tuberculosis than the chest X-ray.