Objective:To investigate the imaging characteristics of chest CT angiography in patients with active pulmonary tuberculosis complicated with pulmonary embolism, so as to improve the detection rate of active pulmonary tuberculosis complicated with pulmonary embolism.Methods:The clinical data of 103 patients with active pulmonary tuberculosis treated in Tianjin Haihe Hospital from January 2013 to January 2020 were retrospectively analyzed, including general conditions, symptoms and complications. According to the occurrence of pulmonary embolism, the patients were divided into active pulmonary tuberculosis complicated with pulmonary embolism group (study group, n=43) and active pulmonary tuberculosis without pulmonary embolism group (control group, n=60). The time between the onset of pulmonary embolism and the onset of tuberculosis of the patients in the study group was collected. The chest CT imaging characteristics of the patients of two groups were analyzed. The imaging characteristics, embolism distribution and secondary changes of the patients in the study group were summarized. Results:Time from onset of tuberculosis to pulmonary embolism of the patients in the study group was about 60 days (14 days to 75 days). The incidence of chest tightness and dyspnea of the patients in the study group was significantly higher than that in the control group (all P<0.05). The number of lung lobes involved in lung lesions of the patients in the study group was significantly higher than that in the control group ( P<0.05). The incidence of lesions in the middle lobe of the right lung, the tongue lobe of the left lung and the lower lobes of both lungs of the patients in the study group was higher than that in the control group (all P<0.05). The incidence of peripheral pulmonary embolism was significantly higher than that of central pulmonary embolism ( P<0.05). However, the incidence of atelectasis, pulmonary artery widening, and right heart enlargement in the patients with central pulmonary embolism was significantly higher than that in the patients with central pulmonary embolism (all P<0.05). Conclusions:Multi-slice spiral CT chest angiography can show some important imaging manifestations of patients with active pulmonary tuberculosis and pulmonary embolism, which is helpful for the early detection of the disease and the improvement of its prognosis. Multi slice spiral CT chest angiography can show some important imaging manifestations of patients with active pulmonary tuberculosis complicated with pulmonary embolism, and timely detection is helpful to improve the prognosis of patients with active pulmonary tuberculosis complicated with pulmonary embolism.