Twelve patients with tuberculous pericarditis were found among 1,194 patients with tuberculosis treated at the University of Texas Medical Branch over a 10-year period, an incidence of 1%. Surgical treatment was undertaken in 4 patients, and the rest were treated medically. The surgically treated patients had no major complications, and none of them died. In the medically treated group, however, 1 patient died, 1 had an anaerobic empyema, and 1 experienced respiratory arrest. In addition, the average hospital stay was 33 days less in the surgically treated group. Early surgical intervention should be carried out in patients with tuberculous pericarditis who do not respond promptly to adequate antituberculosis chemotherapy.