Abstract: Background: Tuberculosis (TB) is still a global problem. The high incidence of TB is due to the less than optimal TB risk factor interventions. This study aims to analyze the risk factors for TB incidence in the coastal area of the lake, Towuti District, East Luwu Regency. Methods: This study used a case-control design conducted in the coastal area of the lake, Towuti District, with a sample of 34 cases and 94 controls. Bivariate analysis and logistic regression were used to analyze the risk factors for the incidence of tuberculosis. Results: The results showed that the significant risk factors for TB incidence were family history (OR = 13,920; 95% CI: 4,36–51,23), household contacts (OR = 3.04; 95% CI: 1.188–7,809), close contact (OR = 8.382; 95% CI: 2.969–24, 852), home ventilation (OR = 14.357; 95% CI: 1.585–669.82), income (OR = 2.609; 95% CI: 1.033–6.675) . Home ventilation is the most dominant risk factor for TB incidence in the coastal area of the lake in Towuti District. Conclusion: TB disease control strategies based on risk factors need to be implemented in coastal areas.