OBJECTIVE To explore the diagnostic value of serum procalcitonin (PCT), interleukin-10 (IL-10), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in community acquired pneumonia (CAP) and tuberculosis (PTB). METHODS 113 CAP cases patients and 78 PTB cases were enrolled from May 2011 to March 2012. Routine blood test, serum PCT, CRP, IL-10 and ESR of patients within 24 hours were analyzed retrospectively. RESULTS The serum concentrations of PCT, IL-10, CRP and ESR in CAP patients with CAP were 0.35±0.017 mg/mL, 0.095±0.004 mg/L, 59.80±5.12 mg/L and 35.00±4.81 mm/1h, respectively, significantly higher than patients with PTB (p < 0.01); According to the result of ROC curve analysis in CAP and PTB, the PTC area under ROC curve is 0.715 (95% CI 0.647-0.782), the sensitivity and specific degree of serum PTC were significant better than CRP and IL10 (p < 0.05). In tuberculosis sputum culture, the serum concentrations of IL-10 and ESR in TB positive group were 0.045±0.013 mg/L and 62.50±8.69 mm/1h, significantly higher than that of TB negative group (p < 0.05); whereas, the concentrations of serum PCT and CRP in TB positive and negative groups had no significant difference (p > 0.05). CONCLUSIONS The levels of serum PCT, IL-10, CRP and ESR in CAP patients are higher than that in PTB patients. Therefore, the serum PCT, IL10, CRP and ESR level is benefit to distinguish between CAP and PTB. This could provide a comprehensible evidence for both diagnosis and prognosis.