Abstract. Tuberculosis is one of the leading causes of morbidity and mortality in HIV patients. Hypovitaminosis D, a defective cell-mediated immune response to mycobacterium tuberculosis infection has been extensively described in HIV patients, but studies assessing the role of vitamin D in TB-HIV co-infection are lacking. We therefore conducted this study to verify hypovitaminosis D possible risk factor of TB- HIV co-infection. Consecutive HIV patients starting ARV and sex, age and CD4 cell count matched were recruited in a case control study in Sanglah Hospital. Tuberculsis has confirmed by presence of acid fast bacilli in sputum or mycobacterium detected in spcimens culture/Gene Xpert/PCR. Vitamin D levels were measured by direct chemiluminescent immunoassay on a LIAISON®25OH analyzer. The study comprised 25 cases and 25 controls, median (interquartile range) 25(OH)D3 serum concentration were 19.80 (12.15-27.45) ng/mL in cases and 33.30 (27.2-39.4) ng/mL in controls (P<0.001). After adjustment for potential confounders included anemia, smoking and low BMI, with multivariate logistic regression analysis,  hypovitaminosis D were independently associated with the development of active tuberculosis in HIV patients.(OR 26.154 (90% CI: 4.371-156.541); p <0.001). The finding indicates that hypovitaminosis D was a risk factor of TB-HIV co-infection.