Clinico-radiological profile of 100 geriatric pulmonary tuberculosis cases hailing from hilly areas of Himachal Pradesh was studied. The clinical presentation was altered due to associated smoking as well as chronic obstructive pulmonary disease. Breathlessness was the main presenting feature. Sixty-five cases had exudative lesions radiologically. Both conventional and short course regimens were equally effective. Drug toxicity was not a major problem. Delayed action taken and poor compliance were main handicaps in such cases. Need for individualized care for geriatric patients is stressed.