Abstract: Introduction: Vascular endothelial growth factor (VEGF) is a potent angiogenic factor. Intense angiogenesis has been found in active pulmonary tuberculosis. VEGF role in tuberculosis (TB) has not been fully elucidated. Aim: This study aimed to measure serum VEGF levels in active pulmonary tuberculosis and changes following chemotherapy. Subjects and Methods: Twenty five consecutive patients with active pulmonary tuberculosis and 15 healthy control subjects were enrolled in this prospective randomized controlled study. Complete medical history, full clinical examination, complete blood examination, erythrocyte sedimentation rate, liver function tests, kidney function tests, fasting blood sugar, radiological examination by plain X ray chest, tuberculin skin test by Mantoux method, sputum for acidfast bacilli by Zeil Neilsen stain and estimation of serum VEGF before treatment, 3 months and 6 months after treatment. Results: There was no statistical significant difference (p value >0.05) between patients and control group regarding age in years (with a mean of 36.75 8.95 for patients and 26.24.4 for control group) and smoking index in packs/year (with a mean of 239.65 215.40 for patients and 190.6 115.2 for control group). There was a highly statistical significant difference(p value