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Objective: To find out the prevalence of active pulmonary tuberculosis (TB) amongst patients of tubercular pleural effusion and to find out any direct association between tubercular pleural effusion and active pulmonary TB. Methods: This was an observational study conducted in eastern India amongst patients of tubercular pleural effusion. Laboratory and radiological investigations were done for all of the patients. Patients with microbiological/radiological evidence of active pulmonary TB were classified as having primary disease. Rest of the patients were classified as having reactivated disease. Results: A total of 50 patients were recruited in this study. Only 4 patients (8%) had radiological/microbiological evidence of active parenchymal TB. There was no difference in terms of demographic and laboratory features between patients with primary and reactivated disease. Conclusion: Active pulmonary TB was found amongst a minority (4%) of cases of tubercular pleural effusion with reactivation of the past or, latent TB infection being responsible for the majority of the cases.