Abstract: In this paper, we reviewed current pathological diagnosis situation of tuberculosis (TB), and the roles of new molecular pathological techniques on TB diagnosis and basic research in China. Compared with other methods, pathological diagnosis has remarkable advantages in making definite diagnosis of TB cases, especially for bacteria negative pulmonary TB and extrapulmonary TB patients. Up to now, pathological diagnosis generally remains on histological and cellular level in our country, mainly focuses on histological characters and finding pathogens. TB-PCR tests are limited to a few department of pathology in large hospitals due to high requirements for laboratory, instruments and technicians. Development of the new subdiscipline molecular pathology has led pathological research and diagnosis approach into detecting biomacromolecules such as protein and nucleic acids, which brin-ging new development opportunities for pathological diagnosis and research of TB. In recent years, molecular techniques have developed rapidly and widely applied in testing sputum and body fluid samples. However, application of these new techniques on tissue samples is rather delayed and needs acceleration for clinical utilization. In future, TB pathological diagnosis should not only rely on histological changes, but also make more efforts in finding pathogens, identifying mycobacteria species, and detecting mutations of drug-resistant related genes, in order to provide more accurate evidences to improve efficiency of TB diagnosis and treatment.