The current article is dedicated to the modem state and improvement prospects of community-acquired pneumonia and pulmonary tuberculosis differential diagnostics. According to the official domestic statistics pulmonary tuberculosis continues to be a serious problem for the Russian Federation. One of the tuberculosis prevention most important factors is its early diagnostics. Unrecognized pulmonary tuberculosis is the leading factor of the in-hospital tuberculosis dissemination. On the basis of the current international and domestic guidelines it is shown that in order to improve the community-acquired pneumonia and pulmonary tuberculosis differential diagnostics it is necessary to introduce mandatory sputum specimens light-emitting diode microscopy and Xpert-testing of all patients admitted with pulmonary tuberculosis suspecion with airspace opacity/consolidation on chest x-ray as well as their isolation until tuberculosis exclusion.