Objectives: Our aim was to evaluate the diagnostic value of pleural fluid TNF-α and IL-10 levels in tuberculous pleural effusion (TPE) and compare with that of ADA. Material and Methods: 70 patients were enrolled in the study. Fourteen patients had TPE, 19 patients malignant pleural effusion (MPE), 18 patients complicated parapneumonic effusion (PPE) and 19 patients had transudative pleural effusion. Results: The pleural fluid TNF-α levels were significantly higher in TPE than MPE and transudates. There was no significant difference in pleural fluid IL-10 levels between groups. Among exudative effusions, TNF-α was significantly higher in tuberculous group, while there was no difference in IL-10 levels between tuberculous and nontuberculous group. The pleural fluid ADA levels were significantly higher in TPE than other groups. ROC analysis was performed and the optimal cut-off points of TNF-α and ADA were 13.3 pg/mL and 41.5 U/L, respectively. The sensitivity of TNF-α was 71% and specificity was 66% in the diagnosis of TPE. In contrast, the sensitivity and specifity of ADA was 78% and 86% respectively. Conclusion: TNF-α is a useful marker in the diagnosis of TPE and IL-10 has no diagnostic value. However, the sensitivity and specifity of TNF-α is lower than that of ADA.