To study the impact of pulmonary tuberculosis on the natural development of spontaneous pneumothorax and on the outcomes of its treatment, data on 589 patients were retrospectively analyzed. Two hundred and eighty patients had primary spontaneous pneumothorax and 170 had secondary nontuberculosis pneumothorax. Tuberculous pneumothorax was in 139 patients, of them 71 had decay cavities. The authors defined the causes of pneumothorax, the severity of respiratory diseases, assessed admission X-ray data, evaluated the efficiency of the first 24 hours of treatment, complications and mortality rates in these groups of patients. The efficiency of treatment for spontaneous pneumothorax has been ascertained to be determined by the degree of lung decay, by the adequacy of pleural cavity drainage, and by the rationality of a tactic algorithm rather than by the type of an infectious agent (Mycobacterium tuberculosis, nonspecific microflora).