Objective To analyze the photographic CT features of sarcoidosis and pulmonary tuberculosis with miliary nodules as their main manifestations , so as to improve the diagnostic accuracy of sarcoidosis and pulmonary tuberculosis by CT .Methods Ret-rospective analyses of the clinical and photographic data were made in the patients with miliary nodules in the lungs as the main manifes -tations.The patients sought medical care in the hospital from December , 2012 to February, 2015.All the patients underwent multi-slice spiral CT scanning of the chest .Detection results showed that there were 17 cases of sarcoidosis and 21 cases of tuberculosis . Results There were no significant differences in the regional distribution of miliary nodules between the 2 groups(P﹥0.05).As for the distribution of miliary nodules , sarcoidosis nodules were mostly distributed along the lymphatic vessels , while pulmonary tuberculosis nodules were distributed at random(P<0.05).If miliary nodules were even in size, it might indicate a higher probability of pulmonary tuberculosis(P<0.05).If the boundaries of nodules were clear and had a fusion tendency , it was highly probable that it was sarcoido-sis(P<0.05).Sarcoidosis combined with lymphadenectasis , air retention, patchy shadow, fibrosis was more common, as compared with pulmonary tuberculosis , however , pulmonary tuberculosis complicated with tree-in-bud tuberculosis , ground glass opacity , pleural dropsy was more frequently seen, as compared with sarcoidosis(P<0.05).Conclusion For sarcoidosis and pulmonary tuberculosis with miliary nodules in the lungs as the main manifestations , from the spiral CT features , significant differences could be seen in the re-gional distribution, structural features of nodules and associated signs and symptoms , so it was of important value for the identification and diagnosis of the disorder .