Abstract: Objective To analyze the prevalence of smear-positive pulmonary tuberculosis (TB) in Tianzhou and propose prevention and control measures.Methods The database of 849 pulmonary TB patients who were sputum smear-positive was set up by Excel 2003 and analyzed by EpiInfo 2003.Results Among the 849 smear positive cases, 765 were firstly treated (92.46%), 64 were re-treated (7.54%).The smear positive rate of TB in out-patient department was 23.62% (849/3595)，the positive rate for males was 23.76% (616/2593) and for females was 23.25% (233/1002)，the difference was not statistically significant (2=0.06, P=0.802).The seasonal distribution of the cases was not obvious.The cases aged 15-44 years accounted for 76.56% (650/849) of the total smear positive cases，and the cases in farmers accounted for 90.81% (771/849) of the total cases.Conclusion Referral and follow up are the main ways to find positive pulmonary TB patient, the timely/accurate case finding and the cure of smear positive cases are the important measures to eliminate infection source and control TB epidemic.