Coexistence of pulmonary tuberculosis and small-cell lung cancer is uncommon. We encountered a 76-year-old male patient with an initial presentation of chest tightness and palpitation for 1 day. Chest radiography revealed a mass lesion in the right upper lung. Chest computed tomography (CT) showed a soft tissue mass at the right upper lobe and patchy infiltration in the left upper lung. Pulmonary tuberculosis was verified by positive sputum acid-fast stain and tuberculosis polymerase chain reaction, and drug sensitivity test showed multidrug-resistant pulmonary tuberculosis. Small-cell lung cancer was diagnosed by the pathology of the CT-guided biopsy. We reviewed related articles in the literature and discuss the relationship between lung cancer and pulmonary tuberculosis.