OBJECTIVE To determine the HIV prevalence rate among tuberculosis (TB) patients in Guangxi, China. METHODS Stratified cluster sampling and systematic sampling methods were used to select 16 clinics from which pulmonary TB patients were recruited to participate in this study. Two thousand three hundred pulmonary TB patients provided information on sociodemographic characteristics, HIV-related knowledge and high-risk behaviors, and method of TB diagnosis. Five-milliliter blood sample from the regular TB check up was retained and tested for HIV antibody. RESULTS HIV prevalence among pulmonary TB patients was 0.5% (12 of 2300). There was statistical difference in HIV prevalence neither between urban and rural nor between male and female patients; however, TB patients from higher HIV prevalence areas had a higher rate of HIV infection than TB patients from a lower HIV prevalence areas for both rural or urban areas (0.8% vs. 0, chi = 7.49, P < 0.01). CONCLUSIONS HIV prevalence is higher among pulmonary TB patients than among the general population in Guangxi. Program to address the dual infections of HIV/TB are needed.