Background: The diagnosis of tuberculosis and lower limb fracture and treatment can affect a patient ‘s’- psychological well being. Development of these psychological problems can affect the overall well being of the patient and make palliation of physical symptoms more difficult. The psychological symptoms may reflect on the individuals’ self esteem, mental adjustment and coping. Objectives: The aim of this study was to determine the prevalence of psychological symptoms, mental adjustment, and coping; in patients with Pulmonary Tuberculosis and fracture admitted to chest units in University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, and the National Orthopaedic Hospital Enugu, Enugu State. The study also aimed to compare the psychological symptoms, coping, and self esteem in patients with pulmonary tuberculosis and lower limb fracture. Method: The study population consisted of 126 patients diagnosed of pulmonary tuberculosis receiving treatment at DOTS clinics and 126 patients diagnosed of lower limb fracture at emergency and out –patients clinic. Socio-demographic interview schedule was used to assess the socio- demographic characteristics of the respondents. The Symptom Checklist-90 was used to assess the extent of psychological symptoms in both respondents and the Index of Self Esteem was used to assess the level of self esteem. The Short Form -12 was used to assess the health outcome and the Brief Cope was used to assess the coping and pattern of adjustment. Results: A significantly higher prevalence of psychiatric disorders was found in the tuberculosis group (25.4%) than in the orthopaedic group (7.6%). The types of psychiatric disorders encountered included depression, anxiety, and paranoid ideation and interpersonal sensitivity (SCL-90). Psychiatric morbidity was higher in tuberculosis patients with low educational attainment, female sex, low income and unemployment. Participants commonly used the coping strategies of religion, acceptance, planning, denial and substance use to cope with the illness. Low self esteem was more prevalent among patients with tuberculosis compare to fracture. Among patients with Tuberculosis, being of a younger age was significantly associated poorer emotional health. Conclusion: The results highlight the need for further efforts to be directed not only at the technological advances in diagnosis, control, and management, but also at improving recognition of the link between physical and psychological health in order to develop a more holistic approach to patient care.