：Objective To assessquantitatively the association between smoking and the risk of disease and death frompulmonary tuberculosis(TB) by a meta-analysis. Methods Both Chinese and Englishliteratures published from Jan. 1999 to Jun. 2010 about the case-control study of theassociation between smoking and pulmonary TB were retrieved by searching the electronicresource databases. A meta-analysis was then performed on the comparison and synthesis offindings from included studies. Pooled odds ratio (OR) and 95% confidence interval (CI)were calculated using a software RevMan 4.2. Finally,possible publication bias was testedand a sensitivity analysis was conducted. Results The meta-analysis for total 22high-quality case-control studies found a pooled OR of 2.56 (95% CI 1. 80 ～3.64)with a random-effects model. Sensitivity analysis showed that pooled OR was 2.56 (95% 1.76～3.71 ) by removing two papers of nested case-control study. The OR were 2.13 (95%CI1.76～2.58) and 4.60 (95% CI 1.81～11.69) for disease and deathfrom TB,respectively. After confounding factors,including age and gender,had beencontrolled the OR was 2.53 (95% CI 1.27 ～5.03 ) whereas 1. 99(95% CI1.54 ～ 2.56 )without control of them. Conclusion Smoking can increase the risk of incidence and deathof TB. TB control programs and treatment of patients might benefit from interventionsaimed at reducing tobacco exposure.