The salient features of pulmonary tuberculosis in 263 Nigerian children are presented. Attention is drawn to the little known diagnostic presence of supraclavicular lymphadenopathy which is often accompanied by pulmonary tuberculosis. In the childhood population where early diagnosis of tuberculosis is sometimes difficult and depends mostly on a high index of suspicion, the finding of such a sign is highly significant and useful. Even though phlyctenular kerato-conjunctivitis has been reported to be caused more often by bacterial antigens other than tuberculosis, the experience in this part of the world is that its presence is still almost pathognomonic of tuberculosis. Outpatient ambulatory management though successful was associated with a high default rate. Suggestions are made on ways to reduce this rate.