: Tuberculosis is contagious infection diseases caused by mycobacterium tuberculosis. Observation from siloam health center district of Tamako in Sangihe Island regency is most patients with pulmonary tuberculosis. Male sex who has the habit of smoking. The purpose of this research to determine the relationship of smoking and the incidence of pulmonary tuberculosis in siloam health center district of Tamako Sangihe Island. Method in this research used analytic survey crosssectional approach. This research was conducted at district of Tamako in October 2014 to January 2015.The samples in this research amounted to 30 people. Sample were taken used total sampling. Data obtained used the questioner and observation sheets. The data were abalysed used univariate and bivariate analysis includes chi square test with. The result of this research showed the values of p=0,01 which means that the p-value is smaller than the value of α=0,05. Conclution that there is a significant relationship between smoking and incidence of pulmonary tuberculosis.Suggested for futher research are expected to further investigate other factors that may cause the incidence of pulmonary tuberculosis.