The pathogenesis of tuberculous pleurisy remains unclear. Evidences have shown that immuno-imbalance is an important risk factor for this condition. The present paper aimed to profile CD4 ⁺ and CD8 ⁺ T cells in patients with tuberculous pleurisy. A total of 30 cases were selected and their peripheral blood and pleural fluid were collected. The mononuclear cells were isolated. The CD4 ⁺ cells, CD8 ⁺ T cells, activation surface markers of human leukocyte antigen (HLA)-DR, and granzyme B level in CD8⁺ T cells were detected by flow cytometry. The results showed that the proportions of CD3 ⁺ , CD4 ⁺ and CD8 ⁺ T cells in peripheral blood samples collected from the patients with tuberculous pleurisy were lower than those in the control group. The proportions of CD3 ⁺ and CD4 ⁺ T cells in patients' pleural effusion were higher than those in peripheral blood, but the proportion of CD8 ⁺ T cells had no significant difference. The levels of HLA-DR on CD4 ⁺ and CD8 ⁺ T cells in peripheral blood in patients with tuberculous pleurisy were higher than those in the control group. And the level of CD8⁺ granzyme B⁺ T cells in patients with tuberculous pleurisy was lower than that in the control group. In patients , the levels of CD4 ⁺ HLA ⁺ , CD8 ⁺ HLA ⁺ and CD8⁺ granzyme B⁺ T cells in pleural effusion were lower than those in peripheral blood. In patients' peripheral blood there was a positive correlation between CD8 ⁺ T cells and granzyme B level. The results suggested that the immune response between peripheral blood and pleural fluid in patients with tuberculous pleurisy were different. Immuno-imbalance may play a critical role in the development/prognosis of the disease.