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Abstract. Simultaneous consumption of tuak, a traditional alcoholic beverage, and smoking is common among Batak ethnic group in Indonesia. The purpose of this study was to find out the association between smoking and alcohol consumption with the risk of Pulmonary Tuberculosis (PTB) in Batak ethnic group in Medan, Indonesia. A matched case-control study was conducted on 100 PTB patients and 100 healthy individuals group. Smoking and alcohol consumption were self reported. Data was analyzed with Epi Info program. Smoking and alcohol consumption habit is significantly difference in case and control group (p < 0.01). After conditional logistic regression analysis with non smoking and non alcohol consuming as a comparative, the Odds Ratio (OR) for the smoking-only group was 4.08 (95% CI: 1.28-13.05); for the alcohol-only consuming group was1.83 (95% CI : 0.11 - 28.95) and for the smoking and alcohol consuming group was 13.7 (95% CI: 4.02 – 46.94). There is an association beetwen smoking and alcohol consumption and the risk of PTB in Batak ethnic group in Medan, Indonesia. Keyword : Pulmonary tuberculosis, smoking, alcohol consumption, Batak.