Objective: To explore the value of Xpert assay, MGIT 960 culture, and smear method in diagnosing pulmonary tuberculosis (TB) using bronchoalveolar lavage fluid. Methods: Bronchoalveolar lavage fluid was collected from 60 patients who were highly suspected of active TB. Xpert assay, MGIT 960 culture, and smear method were used for examination. The comprehensive diagnostic results were used as the gold standard to evaluate the value of the three methods in diagnosing TB. Results: Xpert assay, MGIT 960 culture, and smear method exhibited good consistency in diagnosing TB (Kappa value=0.596, 0.632, 0.275). The sensitivity and accuracy of Xpert assay and MGIT 960 culture for diagnosing TB were significantly higher than those of smear method (P<0.05). The positive detection rate of negative results in diagnosis with smear method using Xpert assay was 86.36%, significantly higher than that of MGIT 960 culture (50.00%). Moreover, the report time of TB resistance results in the former was significantly shorter than that in the latter (P<0.05). The sensitivity, specificity, and accuracy of combined diagnosis of Xpert assay, MGIT 960 culture, and smear method using bronchoalveolar lavage fluid were 89.80%, 90.91%, and 90.00%, respectively. Combined diagnosis was more accurate than the smear method. Conclusion: For in diagnosing TB, the sensitivity of Xpert assay using bronchoalveolar lavage fluid is significantly higher than that of MGIT 960 culture and smear method. Combination of the three methods can achieve early accurate diagnosis and effective prevention and control of TB.