ABNORMALITIES of the peripheral blood are frequent and varied in patients with miliary tuberculosis [l-5]. Anemia, leukopenia, thrombocytopenia, pancytopenia, monocytosis, basophilia, eosinophilia, leukocytosis and leukemoid reactions have been described [6-131. Although granulomas have sometimes been seen in marrow aspiration smears [14-161, they are not usually found since architectural disruption is produced by the aspiration procedure. In contrast, bone marrow biopsy [17, 181 and/or liver needle biopsy [ 19-221 are useful both in the demonstration of granulomas and in establishing the diagnosis of disseminated tuberculosis. In this report, the advantages and disadvantages of both biopsy procedures are compared. The relationship of the peripheral blood changes to the frequency of positive marrow biopsy findings is also examined.