Abstract:Background The elderly are considered to be at high risk for tuberculosis (TB). The objective of this study was to identify factors associated with tuberculosis among adults ≥60 years and provide the basis for prevention and control of senile tuberculosis. Methods A 1:2 matched case-control study was conducted among elderly persons using a structured questionnaire from April, 2016 to April, 2017 in Urumqi, China. The potential influencing factors included sociodemographic characteristics, living condition, behavior, and comorbidities. Based on matching design, a conditional logistic regression was used to identify the influencing factors. Results The study sample included 575 subjects, the age range was 60-89 years old, with 302 males, accounting for 52.5%; Multivariate logistic regression model analysis showed that one person increase per 100 square meters is associated with a 67% increase in the odds of TB development (odds ratio (OR) 1.67; 95% confidence interval (CI) 1.36-2.06; P<0.001). Family income level was also important, with those on less than 5,000 CNY a month associated with increased odds compared with those with monthly incomes over 10,000 CNY (OR 4.72; 95%CI 2.29-9.75; P<0.001). The risk was significantly higher among people going out more than 3 to 7 days per week compared to those going out less frequently (OR 4.53; 95%CI 2.72-7.53; P<0.001). Compared with persons who were not in contact with TB patients, the risk increased among those who had TB contact (OR 3.72; 95%CI 1.45-9.70; P=0.006). Among hypertension patients, the risk of TB onset decreased (OR 0.57; 95%CI 0.35-0.91; P=0.018). Conclusions Five factors were found to be associated with the occurrence of TB among the elderly in Urumqi, China. The future TB control program should pay special attention to the elderly population with characteristics of above risk factors.