Objective　To explore the clinical and pulmonary ultrasonographic characteristics of neonatal congenital pulmonary tuberculosis. Methods　The clinical and imaging data of a case of neonatal congenital pulmonary tuberculosis were retrospectively analyzed and related literature were reviewed. Results　A premature female infant with gestational age of 31+2 weeks suffered from progressive dyspnea, incorrigibility respiratory failure with hepatosplenomegaly, heart failure and leukocytosis 14 minutes after birth. Her mother was diagnosed with miliary tuberculosis 3 days after delivery, and acid-fast bacillus ++ was found by sputum smear acid-fast stain. Pulmonary ultrasonography showed hypo-echo consolidation area in both posterior lungs with multiple hyper-echo patches inside, twinkling with the respiration. Conclusion　Pulmonary tuberculosis can be diagnosed according to the clinical data and the history of the mother. Pulmonary ultrasonography can be used as a diagnostic reference.