Eleven patients with active tuberculosis who showed hilar adenopathy on roentgenographic examination are reported. The relationship of hilar adenopathy and racial predilection is suggested. Special emphasis is placed on differential diagnosis in the adult with hilar adenopathy. The necessity for exact diagnosis, usually to include tissue biopsy, is indicated. The failure of peripheral node biopsy to reveal the true condition in the hilar nodes is noted, indicating the need in such instances for open biopsy of the hilar node or mediastinoscopy.