Nearly 1.7 billion people are exposed to tuberculosis (TB) globally, and low- and middle-income countries (LMICs) are the major contributors to the burden of TB. Malnutrition affects the severity of illness, the effectiveness of treatment regimen, and the recovery process. Moreover, TB is often referred to as a disease of a poor population.  Therefore, this descriptive cross-sectional study was conducted at DHQ Hospital in Bhakkar District and tehsil headquarters (THQ) hospitals in Mankera and Kaloor Kot to assess the nutritional status of TB patients. Data were collected from 329 adult TB patients via a purposive sampling technique with a semistructured questionnaire. Patients’ nutritional status was assessed via BMI and malnutrition indicators adopted from Mini Nutritional Assessment (MNA®). The associations between sociodemographic factors and BMI with malnutrition were analyzed via chi-square tests, with the significance level set at p < 0.05. Among the 329 respondents, 55.6% were at high risk of malnutrition, and 36.5% were malnourished. A BMI of less than 19 was observed in 5.5% of patients, with a statistically significant association between BMI and malnutrition (p = 0.001). However, no significant associations were found between sex or marital status and malnutrition, with p values of 0.194 and 0.339, respectively. The study concluded that malnutrition is prevalent among TB patients, with 36.7% malnourished and 50.46% at risk of malnourishment. The findings revealed no significant associations between malnutrition and sex or marital status, but a significant relationship was observed between malnutrition and BMI, indicating the importance of addressing malnutrition as a critical component of TB management.