Objective: The objective of the study was to determine the management and outcomes of suspected pulmonary tuberculosis admitted to the medical wards of a tertiary and referral hospital in Nigeria Methods: It was a retrospective study of the case records of all suspected pulmonary tuberculosis patients on admission in the medical wards of the hospital between July 2003 and June 2007Result: 166 (9.9%) of 1680 admissions were pulmonary tuberculosis suspects, with 97 (58.4%) males and 69 (41.6%) females. 92 (55.4%) had pulmonary tuberculosis diagnosis confirmed. Other diagnoses made were: pneumonia, 48 (28.9%), bronchogenic carcinoma, 6 (3.6%), congestive heart failure, 7 (4.2%), chronic obstructive pulmonary disease, 15 (9.0%). Median length of time between admission and institution of antituberculosis drugs was 11 daysConclusion: The study shows that the tuberculosis control in Nigeria is in a crisis state. There is need for all stakeholders to find lasting solutions to failure of tuberculosis program in Nigeria and, by extension, sub-Saharan Africa.