Tuberculous pleural effusion is a common cause of pleural effusion in areas with high incidence of tuberculosis. The detection of specific biomarkers is helpful for the rapid diagnosis of tuberculous pleural effusion. The pathophysiology of tuberculosis is to a large extent an immune response, which is closely related to a large number of cytokines and chemokines. Searching for molecular markers that can indicate TPE progression and immune status in pleural effusion is a hot topic in recent years, which is represented by cytokines such as interferon-γ and interleukin family. Some scholars have also proposed new promising diagnostic methods, but more basic research and clinical research are needed to verify them. This article reviews the progress of immune markers and new diagnostic methods in the diagnosis of tuberculous pleural effusion, which can be used as a reference for clinical practice and the development of new diagnostic techniques in the future