ABSTRACT: A population based state wide TB survey was conducted in 2021-2022 in Tamil Nadu, India, among the participants aged 15 and above, to identify the microbiologically confirmed pulmonary TB cases. Population attributable fraction (PAF) was calculated for the state and the districts. In total 130,932 participants were screened across the state and 244 participants were diagnosed with microbiologically confirmed pulmonary TB. PAF for the risk factors for TB with under nutrition (BMI<18.5 Kg/m2) was 39(32-46), alcohol use was 38(30-46), smoking was 31(24-39), and age >60 years was 27(20-34). Krishnagiri 78(23 - 97), Pudukkottai 72(14 -96) and Vellore 71(37–90) districts were having higher PAF values for under nutrition. Wide range was observed due to low sample size. Population attributable risk factors for TB in Tamil Nadu state was higher for under nutrition. Public health interventions could be planned to address this issue accordingly, during TB elimination activities.