Introduction: Tuberculosis is a major public health problem in India. We evaluated the impact of Bacille Calmette Guerin (BCG) vaccine in the clinical spectrum of tuberculosis in children. Material & Methods: A study was conducted over a period of one year from July 2015 to June 2016 in The Department of Pediatrics in PMCH Patna. A total of 100 children up to the age of 15 years suffering from various form of TB attending outdoor or indoor were included in the study. Result: Majority (41%) of children with tuberculosis were below 5 years of age. History of contact with adult tuberculosis was present in 42% of cases. BCG scar was present in 75 % of cases. Pulmonary tuberculosis is seen in 66% and extrapulmonary tuberculosis in 26% cases. Tubercular lymphadenitis was seen in 8% cases of which 87.5% cases were in BCG vaccinated group. Conclusion: Higher incidence of pulmonary tuberculosis in BCG vaccinated group. Higher incidence of tubercular meningitis in BCG unvaccinated group. The underlying risk factor was low socioeconomic status and poor immunization coverage should be taken into consideration in order to reduce morbidity and mortality due to tuberculosis in children