Background: The most economical pleural fluid marker is adenosine deaminase (ADA), which is frequently employed in high-prevalence situations whereas its usefulness is questioned in low-prevalence ones. It is well recognized that the lymphocyte percentage (LP) raises the specificity of ADA for this diagnosis. We evaluate ADA's diagnostic utility for tubercular pleural effusions in this study. Methods: Cases of pleural effusion presented to our hospital were included in the study. The pleural fluid data (total and differential cell count, protein, lactate dehydrogenase-LDH, pH, glucose, ADA, cytology, aerobic and anaerobic culture, Lowenstein-Jensen, and MGITBactec culture) was noted. we also kept track of demographic and clinical information (body temperature on admission, presence of cough, chest pain, and/or dyspnea), as well as serum glucose, protein, and LDH. In pleural biopsy specimens, the histopathological and microbiological results, the final diagnosis, the first and last days of treatment, and the combination of anti-tuberculosis medications administered were all documented. Results: The difference between the mean adenosine deaminase values in the tuberculous pleural effusion group and the non-tuberculous group is statistically very significant (p 0.001). In n=2 of n=22 instances (two patients had bronchogenic carcinoma, and one patient each had lymphoma), the adenosine deaminase level of the non-tuberculous group exceeded the diagnostic cut-off (40 U/L) for TB. N=2 tuberculous individuals had adenosine deaminase levels below 40U/L. Conclusion: The values of ADA found in this study is adequate to quickly (within 1-2 days) diagnose the majority of TPE cases. Additionally, it is the least expensive, comparable accurate, and least intrusive diagnostic treatment. The process of collecting samples for an ADA test is simple and does not require any particular planning.