Shadows in the lungs are primarily revealed through imaging studies, a characteristic feature found in radiology. Clinically, lung shadows can be caused by tuberculosis, various lung tumors, or inflammatory lesions, which are also detected via imaging studies. Hence, the causes of lung shadows are numerous and complex in clinical settings. Discovering a shadow on the lungs through X-ray does not necessarily indicate tuberculosis. A definitive diagnosis should be based on a detailed patient history, other relevant clinical manifestations, and additional diagnostic tests. While tuberculosis might be a likely cause of lung shadows, it is not the cause in every case.