Background: Pulmonary tuberculosis is a major communicable disease worldwide. Tuberculosis and HIV is a major health problem in many parts of world. The National Tuberculosis and Leprosy Program annual report indicates that about 7% of all TB notified cases had co-infection with HIV. The incidence of Tuberculosis HIV coinfection increasing gradually. Materials and Methods: The study is a Retrospective study conducted on 200 HIV reactive patients at ART center in a tertiary care hospital GGH Ongole. Data was analyzed for incidence of tuberculosis in HIV infected patients with CD4 counts and their association between them. Results: Out of 200 HIV infected, 40 were detected with tuberculosis, of them 32 were pulmonary TB and 8 were extra pulmonary TB. In present study 26 (65%) of patients with CD4 count < 200 cells/μ l developed Tuberculosis, 9 (22.5%) of patients with CD4 count 200-400 cells/μl and 5 (12.5%) of patients with CD4 count > 400 cells/μl shows less number of pulmonary and Extra pulmonary TB. Conclusion: There is a strong association between Tuberculosis and HIV. Incidence of TB is more when CD4 count less than 200 cells/μl. So it is essential to screen HIV reactive patients for TB along with CD4 count to prevent complications and mortality. This study showed that incidence of Tuberculosis pulmonary and extra pulmonary in HIV infective patients is significantly higher with CD4 count < 200 cells/µl.