Background: The statement of WHO, there were 22 countries classifi ed as high burden of TB Pulmonary, including Indonesia. The detection of smear positive (BTA+) patients in Indonesia is still low and fi ltering suspect rate also decreased since 2007 until 2010. It is required to improve the detection patient of tuberculosis. Objective: This study aimed to assess the adult pulmonary TB risk factors that infl uence the disease’s incidence in Indonesia. Methods: This observational analytic studies was conducted on March–June 2011. Data source from secondary data of basic health research 2010, that were individuals = 15 years performed sputum examination. Data of cases were 183 people with smear positive and control of 366 people with negative smear. Those are household members and neighbors cases who had never been diagnosed of TB cases by health personnel. This was analyzed with logistic regression. Result: Multivariate analysis showed that risk factors associated with adult pulmonary tuberculosis were age (OR = 0.473, p = 0.018), gender (OR = 1.613, p = 0.027), lighting energy (OR = 1.804, p = 0.032), nutrition status (OR = 2.101, p = 0.009) and household contact with TB patients (OR = 4.355, p = 0.000). The TB risk factors that most infl uenced the disease’s incidence is household contact with TB patients.