Tuberculosis is communicable disease which is common and often deadly infectious disease caused by mycobacterium tuberculosis. Tuberculosis continues to be a major public health problem in the world. The aim of this study is to assess prevalence and associated risk factors of pulmonary tuberculosis. Treatment and development of multidrug-resistant tuberculosis were also considered. Drugs for Pulmonary tuberculosis confirmed cases used in calculating tuberculosis prevalence in Libya which is obtained from archive department of Abu Seta Hospital. Data obtained from 427 files during 2019 determine the incidence and epidemiology of tuberculosis in Libya. For a total of 427 confirmed cases of pulmonary tuberculosis, about 75.0% of the cases were male and most of the patients (55.0%) were within the age group of 20 - 40 years old. Of the study patients, 114 patients (26.7%) were viral infected and most of the viral infected cases were in the age group of 20 - 40 years and the majority of this age group patients (n = 41, 53.2%) were infected with HIV/HCV, while the least percentage in this group age were infected with HIV/HBsAg (01.3%). Among 427 cases, 73 cases (17.1%) were comorbid with other chronic diseases. Of the 73 cases, 54 cases (74.0%) were diabetes mellitus whereas only 1.4% of them had bronchial asthma, Parkinsonism and renal failure. The drug therapy of active tuberculosis disease needs combination chemotherapy to escape the selection of naturally occurring drug-resistant mutants. Amongst current anti tuberculosis drugs, the rifamycins hold the highest potential for shortening treatment and improving effects. Prevalence of smear positive tuberculosis and bacteriologically confirmed that a high rate of tuberculosis among unemployed population. This study reported that the highest incidence rate is found in people who are smokers.