Objective To evaluate the diagnostic value of metagenomics next-generation sequencing(mNGS)combined with X-pert in pulmonary tuberculosis.Methods A total of 98 patients with suspected pulmonary tuberculosis admitted to First People's Hospital of Fuzhou from February 2022 to December 2023 were selected as the study objects.mNGS and X-pert were all examined,and the value of single and combined diagnosis of pulmonary tuberculosis by X-pert and mNGS was analyzed based on clinical diagnosis results.Results Of the 98 suspected patients,50 cases(51.02%)were clinically diagnosed as pulmonary tuberculosis,48 cases(48.98%)were non-pulmonary tuberculosis.The specificity and positive predictive value of mNGS combined with X-pert in the diagnosis of pulmonary tuberculosis were the same as those of mNGS,both being 100.00%.The diagnostic accuracy and sensitivity of mNGS combined with X-pert were 87.76%and 76.00%,which were higher than those of X-pert(72.45%and 52.00%)and mNGS(79.59%and 60.00%),and the differ-ences were statistically significant(P<0.017).There was good consistency between the combined diagnosis of pulmonary tuberculosis with X-pert and mNGS(Kappa=0.756,P<0.05),while the consistency between single detection and clinical diagnosis was poor(Kappa=0.454,0.595,P<0.05).Conclusion mNGS combined with X-pert can improve the detection rate of pulmonary tuberculosis,which is worthy of clinical promotion.