Background: Tuberculosis is remains to be a major public health problem. Lifestyle factors that have been shown to influence the burden of tuberculosis. The aim of this study is to determine association of lifestyle with pulmonary tuberculosis among hospitals patients in Asir region of Saudi Arabia. Materials and Methods: It is a Case- control study which was conducted in the tertiary care hospital of from April 2019 to July 2019. Total 135 participants were selected through simple random sampling and sample was divided into 67 cases and 68 controls. Cases were included from hospital database and controls were selected from outpatient department of same hospital with respiratory disease other than tuberculosis. Lifestyle Factors associated with tuberculosis were analyzed using logistic regression. Results: After adjustment of covariates, the resulting factors were significant: patient with overweight and obese [OR=4.40, 95% CI 1.27-15.25 and 2.38 (1.61-9.22)], Smoker [OR=1.34, 95% CI-0.52-3.43], abnormal sleep at night (<8 hours) [OR=5.03, 95% CI-1.57-16.10], blue color job worker [OR=2.69, 95% CI-1.02-7.28], frequency of eat outside (>3 day/week) [OR=1.75, 95% CI 1.01-3.01], Besides hunger other reason (s) do you eat [OR=2.08, 95% CI-1.02-5.27], physical exercise < 3 days/week [OR= 1.41, 95% CI 1.21-3.47]. Conclusion: The result of study was found that strong association of lifestyle factors with pulmonary tuberculosis. There is need of interventions which focused on improving the quality of life of tuberculosis patients by removing the lifestyle risk factors.