Objective: To explore the effect of case management mode in tuberculosis pri- mary treatment. Methods: A total of 90 newly treated smear-positive pulmo- nary tuberculosis patients (all eligible) admitted to the tuberculosis department of a city from May 2018 to August 2019 were randomly selected into 45 cases in the control group and 45 cases in the intervention group. The control group gave the usual care mode, and the intervention group gave the tuberculosis case management mode based on the usual care mode. Comparison of awareness rate of disease knowledge, imaging examination and sputum negative conversion rate between the two groups at the end of the month of the intervention. Re- sults: Six months after the implementation of the case management mode inter- vention, the awareness rate of the intervention group increased significantly compared with the control group, and the total awareness rate of disease know- ledge of the intervention group was as high as 91.1%. The focal efficiency was 77.80% and 93.3% respectively, 82.22% and 97.77% respectively; 97.77% was significantly higher than 84.44% (P <0.05) and was statistically significant. Conclusion: The application of case management mode in the primary treat- ment of smear-positive TB patients can effectively improve the know- ledge-Belief-action level of TB patients, improve the cognition degree of the disease, and actively promote the prognosis.