Objectives: To study the relationship between pulmonary tuberculosis and hypolipidemia. Methods: It was a case control study where 80 participants attending our hospital were enrolled after their written and informed consent. Case group was composed of 40 patients having pulmonary tuberculosis based on sputum AFB staining by direct microscopy and/or X–ray chest findings while in control group 40 normal healthy individuals were included. Demographic data, history, anthropometry, sputum AFB by direct smear, chest X– ray and lipid profile of all subjects were recorded. Total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) were compared between two groups. Results: A significantly high number of participants had lower than normal levels of TC, HDL and LDL in case as compared to control group. There were lower than normal levels of TC in 52.5% (21) subjects in case group and 12.5% (5) in control group (P<0.0001), where as 35% (14) subjects in case group and 10% (4) in control group (P=0.007) had below normal levels of HDL. LDL values were found to be lower in 80% (32) participants in case group and 52.5% (21) in control group (P=0.009). Thus, in our study, we observed a significantly higher prevalence of hypolipidemia amongst pulmonary TB patients, as compared to normal healthy individuals. Conclusions: The findings of our study are consistent with the hypothesis that low lipid levels are associated with high incidence of tuberculosis. In our country, hypolipidemia is often a consequence of poor nutritional and lower socioeconomic status, which is proven to be associated with a high incidence of tuberculosis. The effect of low lipid level on occurrence of tuberculosis needs to be studied in detail at molecular level and further research is warranted to support the hypothesis of providing fat rich diet to tuberculosis patients to fasten their recovery.