Intraoperative (n = 290) and autoptic (n = 246) materials obtained from tuberculosis hospitals in 2005-2007 were examined to study the pathomorphism of pulmonary tuberculosis. The study revealed an increase in the number of patients with acute pulmonary tuberculosis. Fibrocavernous tuberculosis halved as compared to the 1980s. Incapsulated pulmonary tuberculosis is prevalent in the phthisiosurgical material (more than 70% of cases). The leading cause of pulmonary tuberculosis was progression of a specific inflammatory process while cardiopulmonary failure and visceral amyloidosis became rare causes of death. The higher incidence of poorly progressive pulmonary tuberculosis in males (they accounted for 85% of the number of death cases) was associated with concomitant and aggravating diseases, such as alcoholism, drug addiction, and HIV infection (68.5% of cases).