With the ageing of the population, the incidence of pulmonary tuberculosis in the elderly has peaked. Elderly patients with pulmonary tuberculosis are easily misdiagnosed. In terms of treatment, the elderly are characterized by low success rate of treatment and high mortality. In particular, elderly pulmonary tuberculosis patients who are not detected in time and treated effectively, are the source of infection in places where people congregate, such as nursing homes and hospitals. The seriousness of pulmonary tuberculosis in elderly deserves greater recognition from the medical staff, especially respiratory physicians, infectious disease physicians and geriatricians. It is important to formulate and implement expert consensus on diagnosis and treatment of elderly pulmonary tuberculosis in accordance with China's national conditions in order to improve the early diagnosis rate of elderly pulmonary tuberculosis in China, standardize the treatment plan, improve the treatment outcome and to reduce the risk of transmission. This consensus covers the definition, epidemiology, immune status, risk factors, diagnosis and treatment of pulmonary tuberculosis in the elderly, and provides 20 recommendations for clinicians.