Objective To analyze the effect of MSCT and DR in the diagnosis of pulmonary tuberculosis with lung cancer.Methods: The patients with pulmonary tuberculosis and lung cancer who were diagnosed and treated in our hospital from January 2019 to December 2021 were taken as the study objects, with a total of 66 cases.MSCT/DR was performed for patients, and the situation under different examination methods was analyzed. Results: Compared with the results of the two examinations, the diagnostic coincidence rate of patients with pulmonary tuberculosis was higher under MSCT examination; The diagnostic coincidence rate of lung cancer is higher; The diagnostic coincidence rate of pulmonary tuberculosis with lung cancer was higher; The overall detection rate of lung cancer is higher; The total detection rate of lymph node enlargement was higher; P<0.05; Conclusion: The use of MSCT examination for patients with pulmonary tuberculosis and lung cancer can judge the lung lesions of patients, which is conducive to the diagnosis and follow-up treatment of the disease.