Background: The deadliest combination of the two devastating and killer disease TB & HIV has been closely linked since the emergence of AIDS contributing the progress and pathogenecity of each other, and as half of the HIV patients are likely to be infected with tuberculosis, the twin challenge of this CURSED DUET seems to be daunting. There has been increase rate of DR TB, MDR TB, XDR TB, which are difficult to treat and contribute to increase mortality. Objectives: To study and co–relate clinical and radiological features of Pulmonary TB in HIV positive patients, comparison with degree of immune suppression. To compare the CD T–cell count and sputum status before and after ATT 4 treatment completion. Material and Methods: This was a prospective cohort study conducted on 50 patients under Department of Radiology, Saraswati Medical College, Unnao from Jan 2018 to Dec 2018. The patients included in the study were all TB patients of age >18 years with strong clinical suspicion of HIV/AIDS. Pulmonary TB was diagnosed either with sputum smear positive or Chest x–ray. When EPTB was suspected as a possible diagnosis, every attempt was made to procure tissue/relevant body fluid for diagnostic testing. Rapid tests are in vitro qualitative tests for the detection of antibodies to Human Immunodeficiency Virus (HIV) types 1 &2 in human serum, plasma, whole blood, urine, saliva was used for diagnosis of HIV. Patients with only extra Pulmonary Tuberculosis and no evidence of pulmonary tuberculosis and Patients with PCP, fungal infection and sepsis were not included because these conditions cause lymphopenia and decreases CD T–cell count. Results: Out of these 50 patients, most of the HIV–TB co–infected patients (62.5%) were seen among sexually active age group of 25–44 yrs. 80% of the patients were male and 20% were females. Most frequently encountered symptoms were fever (80%), cough (70%), loss of appetite (70%) and loss of weight (60%). About 80% cases were moderately or far advanced disease on the chest radiograph. The typical radiological findings of post primary TB, i.e. upper zone infiltrate, fibrosis and cavities were found in 24%, 4% and 6% cases respectively. Cavitary lesions were more in CD4 count above 100. Overall sputum positive PTB was 76% and sputum negative PTB was 24%.Conclusion: Treatment of HIV–TB co infection requires strong commitment and a focused approach. A strong coordination between the national TB and AIDS control programmes is required for effective management of TB–HIV patients.