ObjectiveTo investigate the application value of tuberculosis T cell test (T-SPOT.TB) in the clinical diagnosis of children's tuberculosis. MethodsThe children were selected from Anti-TB Institute of Shantou and the Second Affiliated Hospital of Shantou University from March to December, 2012; they were classified into 4 groups:tuberculosis group (112 cases), non-tuberculosis group (58 cases), high risk of tuberculosis group (60 cases) and healthy control group (60 cases). In each group, the T-SPOT.TB, tuberculin test (PPD), tuberculosis antibody detection (TB-DOT), the sputum smear acid fast stain, and the sputum mycobacterium tuberculosis culture were performed. The sensitivity and specificity of each clinical testing method was compared. The statistical analysis was also performed in the tuberculosis group according to subsection grouping:negative/positive tuberculosis culture, the in-pulmonary/extrapulmonary tuberculosis and the normal immune/immunodeficiency hosts. ResultsIn the tuberculosis group, the T-SPOT.TB has a diagnostic positive rate of 92.9%, significantly higher than that of other clinical testing methods (χ2=9.33, P<0.01; χ2=81.71, P<0.01; χ2=142.00, P<0.01; χ2=101.71, P<0.01). In the non-tuberculosis group, the T-SPOT.TB has a false diagnostic positive rate of 3.4%, a little higher than that of sputum smear and sputum culture, but similar to that of TB-DOT, and much lower than that of PPD test (27.6%; χ2=12.89, P<0.01). In the high risk of tuberculosis group, the T-SPOT.TB has a diagnostic positive rate of 25.0%, higher than that of TB-DOT, sputum smear and sputum culture (P<0.05). In the healthy control group, the T-SPOT.TB has a specificity of 95.0%, significantly higher than that of PPD test (71.7%; χ2=11.76, P<0.01). T-SPOT.TB has a good sensitivity in all of the subsection groups:negative/positive tuberculosis culture, the in-pulmonary/extrapulmonary tuberculosis and the normal immune/immunodeficiency hosts (P>0.05). The total coincidence rate of T-SPOT.TB with the PPD test result was 78.6%. ConclusionT-SPOT.TB has a relatively higher sensitivity and specificity in the diagnosis of children's tuberculosis. With objective and accurate results and less interference factors, it shows a relatively higher clinical application value in the diagnosis of children's tuberculosis.