Objective To discuss value of the CT features of atypical pulmonary tuberculosis with pulmonary interstitial changes and improve the early diagnosis of pulmonary tubeculosis. Methods The CT imaging data of 44 patients with atypical pulmonary tuberculosis with interstitial changes was collected from January 2018 to December 2018,and the imaging characteristics were analyzed. Results In 44 cases of atypical pulmonary tuberculosis,14 cases of atypical pulmonary tubeculosis were the localized distribution,13 cases were mainly in the right upper lobe,and 30 cases were diffuse distribution. The atypical pulmonary tuberculosis of the localized and diffuse distribution mainly with interstitial changes was characterized by tine reticular shadow,micnodule,thickening of bronchiole wall and thickening of interlobular Septa. Tree-bud sign and ground-glass shadow were common in diffuse distribution,and the proportions of cavity,bronchiectasis,mediastinal lymphadenopathy calcification,pleurisy and bullae were higher than that in localized distribution. The atypical pulmonary tuberculosis patients with localized pulmonary interstitial changes (14 cases) have a favourable prognosis,13 cases with significant absorption,1 case with favourable absorption,and 18 cases with the atypical pulmonary tuberculosis patients with diffuse pulmonary interstitial changes (30 cases) with significant absorption,6 cases with no absorption or poor absorption. Conclusion The atypical pulmonary tuberculosis with interstitial changes has its characteristics,and the CT features is helpful to improve the clinical diagnosis and better evaluation of treatment prognosis.