We present the case of a 19 year old female patient who; while being pregnant, developed a miliary tuberculosis (TB) and on adult respiratory distress syndrome (AROS). The hepatic biopsy revealed caseous granulomas and Longhand cells. The patients required CMV with PEEP. She received TB treatment with SM, INH, RMP and PZ. She also received systemic steroids. The patients recovered unsatisfactory presenting bilateral barotrauma, bronchopleural fistulas and finally dies. A review is mode about the few publications on the association of miliary TB and the ARDS.