Coinfection with pulmonary tuberculosis and Cryptococcus species in an immunocompetent patient is uncommon, and sometimes the diagnosis is missed as the two infections share similar clinical manifestations. We encountered an 83-year-old male patient with the initial presentation of cough, sputum production and fever for 2 weeks. He denied any other remarkable history or systemic disease except chronic kidney disease, stage 2. Chest radiograph and computed tomography revealed a left upper lobe cavitary lesion with centrilobular nodules. Pulmonary tuberculosis and cryptococcal pneumonia were verified by positive sputum acid-fast stain and tuberculosis polymerase chain reaction, along with a positive serum cryptococcal antigen test. We also reviewed the literature and discussed the mechanism of coinfection with pulmonary tuberculosis and cryptococcosis.