Abstract: Objective Through analyzing the tuberculosis epidemic situation in Enshi prefecture in order to provide a scientific basis for further control of tuberculosis epidemic. Methods We collected the data of 8 counties from TB Control Monthly and Quarterly report and TB information management system from 2006 to 2010. A total of 58 549 cases of TB suspects visited TB dispensaries during this time period in all counties, among which, 22 316 active TB patients were registered, and of them 12 175 cases were smear positive pulmonary tuberculosis. Results The average annual active TB registration rate was 123.26/100 000(22 316/18 104 321), with the highest in 2007(132.09/100 000, 4775/3 614 899), and declining by year afterwards(129.04/100 000 in 2008,124.46/100 000 in 2009,111.96/100 000 in 2010) (χ²_{active TB}=76.58,P=0.000). The annual registration rate of smear positive and new smear positive was 67.25/100 000 and 52.53/100 000 respectively, both highest in 2006(78.29/100 000 and 61.06/100 000),showed a decreasing trend afterwards (66.17/100 000 and 51.79/100 000 in 2007, 66.14/100 000 and 51.40/100 000 in 2008, 65.10/100 000 and 50.86/100 000 in 2009, 60.53/100 000 and 47.56/100 000 in 2010) (χ²_{smear positive}=93.94,P=0.000;χ²_{new smear positive}=70.44,P=0.000). The annual registration rate of active TB was highest in Xianfeng county(165.03/100 000), lowest in Laifeng County(97.63/100 000). The male annual active TB and new smear positive registration rate(158.56/100 000,68.63/100 000)were higher than female(84.95/100 000,35.07/100 000) (χ²_{active TB}=1989.04,P=0.000;χ²_{new smear positive}=969.27,P=0.000). In terms of occupation, farmers accounted the highest proportion in active and new smear positive TB, 80.70%(18 008/22 316) and 81.71%(7771/9511)respectively. Conclusion The TB epidemic showed a declining trend from 2006 to 2010, however remained at a high level, there is a need for the government to increase the funding input, and promote the full implementation of DOTS strategy.