Anemia stands out as a widespread health issue, playing a substantial role in the global disease burden. The significant occurrence of anemia in tuberculosis (TB) is concerning due to its correlation with delayed sputum conversion, severe manifestations of TB, TB-related mortality, and TB relapse. The current retrospective research aims to explore the prevalence of anemia amongst 117 recently diagnosed with pulmonary tuberculosis (PTB) and to determine potential risk factors that are related to the condition, within a tertiary care centre in South India. In the present study, the prevalence of anemia was found to be 75.2% in PTB patients and among them, 61.3% had mild anemia, 23.8% had moderate anemia and 14.9% had severe anemia. Moreover, normocytic normochromic anemia was the most common finding (58%). Multivariable logistic regression analysis showed that anemia was significantly associated with gender distribution, alcohol consumption, smoking habits, clinical suspicion with pallor, reduced hemoglobulin count, reduced red blood cell counts, increased leukocytes and neutrophil counts along with reduced lymphocytes, eosinophils and monocyte counts (p < 0.05*) suggesting their significant contribution of anemic risk in PTB patients. This association could be due to the impact of TB on the body’s nutritional status and immune response. Therefore, anemia was shown to be much more common in individuals with the most severe clinical presentations of PTB, emphasizing that it may serve as an indicator of the severity of TB. Addressing anemia through targeted nutritional and medical interventions could potentially enhance immune competence and improve TB treatment outcomes.