 Background Pulmonary tuberculosis is the one of the main health problem among Sudanese diabetic patients who are considered as immune-compromised patients.  Objectives of this study To evaluate the different cytokines among study groups ( diabetic and tuberculosis patients, non diabetic tuberculosis patients, diabetic and cardio vascular disease patients and healthy individuals). And detection of Mycobacterium tuberculosis using Real Time PCR.  Methodology This study was designed as descriptive a prospective, analytical case-control study. This study was enrolled 402 individuals’ 40 were diabetic and tuberculosis patients, 41 non diabetic tuberculosis , diabetic CVD were 160 and 161 healthy control. Five ml of blood withdraw in plain vaccutainor after informed consent from individuals whom participate in this study . We measured the cytokines,(IL6 ,IL10 and TNFα) levels from all participant using direct ELISA technique . Then the Real time PCR was done for all participants.  Results The mean levels of IL6 was recorded in 161 healthy persons 94.80. while recorded 196.27 in 41 tubercles non diabetic patients 210.27. in 40 tuberculous diabetic patients and 297.42 . in 160 patients with CVD, TB and diabetic199.33. The mean levels of IL10 was recorded in 161 healthy persons mean 4.21. while recorded mean 8.84 in 41 tubercles non diabetic patients , mean 8.61 in 40 tuberculous diabetic patients and mean 7.90 in 160 patients with CVD, TB and diabetic. The mean levels of TNFα was 81.59 pg/ml in 161 healthy persons. while it was 232.29 pg/ml in 40 tubercles non diabetic patients , 261,78 in 40 tuberculosis diabetic patients and 297.42 in 160 patients with CVD, TB and diabetic. Real time PCR was positive among T.B patients and it was strong in 192 patients group ,while it was negative It was a weak positive in 49 patients and negative in 10 cardio vasulour disease. It was negative in all healthy control 161 individules.  Conclusion TNF was elevated in all groups of tuberculosis patients regardless they were diabetic or not. All T.B patients showed positive result by Real time PCR .63 % from CVD with T.B and DM showed positive result. The estimation of cytokines with combination with real time PCR showed strong correlation.