Background: Pulmonary tuberculosis (TB) and lung cancer are two major global health concerns that often present with similar symptoms, making diagnosis challenging.Case report:We present a case series of five patients who were initially misdiagnosed with pulmonary TB but were later found to have lung cancer.The patients presented with non-specific respiratory symptoms, and initial chest X-rays and empirical treatment for TB did not lead to a definitive diagnosis. Further investigation, including computed tomography (CT) scans, bronchoscopy, and histopathological examination, revealed underlying lung cancer. The cases highlight the importance of thorough diagnostic evaluation in patients presenting with non-specific respiratory symptoms. Misdiagnosis of lung cancer as pulmonary TB can lead to delayed diagnosis and inadequate treatment. A comprehensive diagnostic approach, including CT scans, bronchoscopy, and histopathological examination, is essential to ensure accurate diagnosis and timely management.Conclusion: Lung cancer is often misdiagnosed as pulmonary TB, leading to delayed diagnosis and progression of disease. A thorough diagnostic workup is essential to differentiate lung cancer from pulmonary TB and ensure timely treatment.