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Goal of the study: to define the interaction procedure between phthisiologists and neurosurgeons when managing local tuberculosis of central nervous system in HIV-infected patients. Materials and methods. Histological, mycobacteriologic and X-ray features of CNS tuberculosis were studied in 73 died and 5 operated HIV-infected patients. Results. Stepwise treatment of the patients with local HIV-associated tuberculous lesions of brain includes conservative treatment with the search for the causative agent in all available biological liquids, and should the therapy fail then the decision is made about biopsy for diagnosis confirmation and sensitivity testing and the consequent decision about surgery aimed to remove the lesion. The surgery can be performed only after the relevant anti-bacterial treatment in compliance with drug sensitivity data till perifocal edema is not visible on the brain images.