The microcirculatory bed (MCB) of visceral pleura (19 resected lungs) in focal forms of tuberculosis was studied. MCB changes were of systemic character and were more pronounced in the postcapillary-venular link. The causes of the development of the observed structural-functional changes in MCB include tuberculosis as an inflamation of the immune nature, the possibility of tissue manifestations of therapy pathology, and the influence of stress operation situation. Venulites are first described as a manifestation of immunopathological reaction in focal pulmonary tuberculosis. Irreversible MCB changes in focal forms of tuberculosis, despite the limited pulmonary process and clinical lack of functional changes in the respiratory and cardiovascular system of the patients, are an additional proof in favor of the necessity of early etiotropic therapy and may be used as a prognostic sign in morphological examinations of the operation material.