Tuberculosis is a major public health problem in Nigeria. Drug resistant tuberculosis is now common place due to poor patient compliance and lack of detection of resistant strains. The occurrence of HIV has been responsible for an increased frequency of tuberculosis. Knowledge of the blood picture in pulmonary tuberculosis, is believed, will be a valuable tool in the management of patients. This study aimed at providing information on haematological changes in pulmonary tuberculosis. A total of 200 subjects were investigated. One hundred of these were pulmonary tuberculosis patients comprising 62 males and 38 females who attended the University of Calabar Teaching Hospital and the Dr. Lawrence Henshaw Memorial Hospital (Infectious Diseases Hospital), Calabar, Cross River State; while the remaining 100 were non-pulmonary tuberculosis subjects comprising 50 males and 50 females who served as control subjects. Standard techniques were used for the assays. Routine haematological analyses were carried out which included Packed Cell Volume, Haemoglobin concentration, Mean Cell Volume, Mean Cell Haemoglobin, Erythrocyte Sedimentation Rate, Platelet and Total White Blood Cell counts. Age and gender were also evaluated in the enrolled subjects. Results showed significantly lower values (p<0.05) for Packed cell volume, haemoglobin concentration and mean cell haemoglobin concentration in pulmonary tuberculosis patients than in control subjects while mean cell volume and erythrocyte sedimentation rate showed significantly higher values in pulmonary tuberculosis patients than in control subjects. Packed cell volume, Haemoglobin concentration, Mean Cell Volume, Mean Cell Haemoglobin, and Erythrocyte Sedimentation Rate of pulmonary tuberculosis patients co-infected with HIV were significantly affected (p<0.05). The highest prevalence rate of infection (60%) occurred in the age group (10-30) years. In conclusion, the study showed that tuberculosis had significant effects on the haematological parameters analysed which were in turn aggravated in co-infection with HIV.