〔Abstract〕 Objective To explore the estimation and comparison of fluid volume of tuberculous pleural effusion by B-ultrasound and X-ray. Methods The B-ultrasound and X-ray examination data of 125 patients with tuberculous pleural effusion treated in Qingyuan Chronic Disease Prevention and Treatment Hospital from January 2018 to December 2019 were analyzed retrospectively. Results There was no significant difference between the results of B-ultrasound evaluation of pleural effusion and the actual extracted pleural effusion (P > 0.05); while the X-ray assessment was compared with the actual amount of pleural effusion taken out and the results of B-ultrasound evaluation, the differences were statistically significant (P < 0.05). Conclusion B-ultrasound has high application value in the examination of patients with tuberculous pleural effusion. Therefore, when judging whether there is a small amount of pleural effusion and pleural adhesion, B-ultrasound can achieve ideal results.