Tuberculosis (TB) is an important public health problem worldwide and in Somalia and is a significant cause of death and disease burden due to untreated advanced cases. Despite its prevalence in the country, limited awareness of TB (including healthcare professionals) is one of the most important reasons for underdiagnosis and one of the most important obstacles to achieving the targets of fighting TB in Somalia. In this study, it was aimed to document the radiological signs of pulmonary TB in 206 patients with radiological imaging results among the patients (n=220) who applied to a tertiary hospital serving in Mogadishu and were found to have a positive sputum smear result. The study includes retrospective evaluations of X-ray radiographs of 155 patients and computed tomography (CT) images of 51 patients. Of the 206 patients included in the study, 73.3% (n=151) were male and 26.7% (n=55) were female, and the average age of the study group was 38.5±18.99 years (age range was 3-90 and median was 32, patients were 16 and over, except for a three-year-old child). In patients who are all HIV (human immunodeficiency virus) negative, the most common radiological findings are; nodular opacities were determined as (76.2%), patchy infiltration (62.1%), cavitation (46.1%) and consolidation (45.1%). The majority of the patients were newly diagnosed TB patients, and 14.8% (23/155) of the patients for whom data was available were patients with a history of TB. However, radiological findings showed that the majority of patients had postprimary TB infections. According to accessible retrospective records, 89.3% of the patients had cough, 83.3% had sputum production, and 83.2% had chest pain. Considering the distribution of the lesions, 50.3% of the patients with X-ray results and 70.6% of the patients with CT results had bilateral involvement. The upper lung zones were most frequently affected in both X-ray (81.3%) and CT imaging (78.4% and 74.5% for right and left, respectively). In this study, advanced disease findings and permanent damage were observed in a significant portion of the patients, and extra pulmonary spread was also observed in some patients. All these data show that tuberculosis patients in Somalia are diagnosed late and that there are significant disruptions in the treatment process.