Female genital tuberculosis (FGTB) causes severe and irreversible damage to thernreproductive organs, most commonly the fallopian tubes and the uterus, ultimately resulting inrninfertility. Diagnosis of FGTB is often difficult because of the inaccessibility of the affectedrnorgans, requiring invasive procedures including surgery. There is a strong need for arnsimplified and reliable diagnostic technique. This is even more urgent today than in the pastrnbecause of the spread of HIV / AIDS and the unknown magnitude of FGTB under the currentrnepidemic situation. We studied twenty-five gynecological patients diagnosed clinically asrnFGTB at the Black Lion Hospital for laboratory evidence of etiology and for possiblernassociated immunodiagnostic indicators. Biopsy and curettage samples were taken from eachrnpatient and investigated with histopathology, smear microscopy, culture and polymerase chainrnreaction (PCR) for Mycobacteria. Culture positive samples were examined for the type ofrnspecies. Peripheral blood mononuclear cells were stimulated in vitro with mycobacterialrnantigens for recall responses with lymphocyte stimulation Test (LST). Cytokines: IL-IO,rnTNF-a and INF-y were measured from the supernatant of cultured PBMC. CD4:CD8 ratio inrnblood was evaluated by flow cytometry. Serum IgG, IgA and IgM levels to Mycobacterialrnantigen (MPT59) were also measured by ELISA. The study subjects were all in child bearingrnage (18-39). Of the 17 patients whose infertility status was known, 6 (35.3) had primary whilernII (64.7) had secondary infertility... Among the 25 gynecological patients investigated, only Irnwas AFB smear positive, 3 were culture positive, 7 were histology positive and 12 werernpositive by PCR (a total of 16 positives). CD4:CD8 ratio was not helpful indicator for FGTB.rnThe serum antibody level did not distinguish between laboratory 'positive' and 'negative'rncases. However, all 'patients' had detectable level of one or more of serum IgG, IgA and IgMrnto MPT59. 'Patients' and 'controls' showed remarkable difference in their proliferativernresponse to PPD suggesting its diagnostic value. The result clearly showed that FGTB is arnrather common clinical problem among Ethiopian gynecological patients and its causativernagent is mainly MTB. As far as this work goes, the only diagnostic method to support thernclinical suspicion is the LST to PPD.