In Myanmar, tuberculosis is one of the major public health problems and recent estimates suggest that 1.66% of Myanmar population become infected with tuberculosis every year. The common causes of pleural effusion in Myanmar are tuberculosis and bronchogenic carcinoma. Evaluation of exudative pleural effusion includes studies of pleural fluid and blind needle biopsy of pleura using Abram's pleural biopsy needle or Cope's biopsy needle. However following these procedures some patients are still undiagnosed. Correcting this diagnostic deficiency the author's main interest is pleural fluid Adenosine deaminase to search for tuberculosis in pleural space. Within the study period, 187 patients with various causes of pleural effusion admitted to the Department of Respiratory Medicine, Yangon General Hospital, Myanmar were studied. In this study, the author found out pleural fluid Adenosine deaminase assay is highly sensitive and specific test suitable for rapid diagnosis of tuberculous pleural effusion.