Introduction. According to the World Health Organization, the number of people infected with tuberculosis (TB) in 2020 was 9.9 million. It is expected that diabetes mellitus (DM) will become the most common health problem, as the number of patients may reach 592 million by 2035. TB and DM occur in the type of "mutual burden syndrome", which makes the two diseases more socially significant, given the increase in incidence. Aim: to study the radiological features of pulmonary tuberculosis and regional drug resistance of MBT in patients with DM. Material and methods. A retrospective analysis of 80 case histories of DM patients with pulmonary tuberculosis was carried out. Statistical processing of the obtained data was carried out using Microsoft Office Excel 2021 software (Microsoft, USA) and an online service medstatistic.ru. Results. As a result of the study, it was revealed that of the 80 registered cases, 73.75% were men and 26.25% were women, the average age of patients was 49.9±3.6 years. Harmful habits were detected in 65.1% of patients with TB and SSD. Infiltrative tuberculosis of the right lung (20.0%), disseminated tuberculosis of the right lung (20.0%), disseminated pulmonary tuberculosis (20%) and tuberculosis of the right lung (20.0%) often developed, while in the vast majority of cases the decay phase was recorded. Blood and urine tests, as well as serological studies, were used as diagnostic methods. Based on the results of computed tomography, the affected lung segments are reflected. Lung TB patients were treated jointly with related specialists. Discussions. A high incidence of complications of DM, developing against the background of prolonged decompensation, was revealed. Resistance to anti-tuberculosis chemotherapy drugs was detected in 31.25% of cases. It is possible to achieve a positive result from anti-tuberculosis therapy with the appointment of adequate therapy regimens, compensation for diabetes and compliance with the treatment regimen. Conclusions. Нарушение режима лечебного учреждения, низкий комплаенс пациентов к лечению приводит к необходимости поиска новых средств противотуберкулезной терапии, с учетом региональной лекарственной устойчивости МБТ у пациентов с СД, и рентгенологических особенностей туберкулеза легких для своевременности диагностики.