Background: Tuberculosis (TB) is a major world health challenge affecting more than 9 million people every year of which more than 1 million are children. It presents non-specific symptoms and for this reason has been described as a silent epidemic, especially in the diagnosis of childhood TB, especially in bacteriological confirmation. Understanding the risk factors of TB in children is therefore important. Objectives: to describe socio-economic, environmental, and health related characteristics of childhood TB patients in Nowshera, Pakistan, and their risk factors in order to propose public health interventions. Study design: A Cross-Sectional-Study Place and duration of study : This research study is proposed to be conducted in Nowshera Medical College / Nowshera Medical College / Qazi Hussain Ahmed Medical Complex situated in Nowshera, Khyber Pakhtunkhwa province of Pakistan over a period of eight months starting from the first of 03 March 2022 to 03 December 2022 Materials and Methods: A cross-sectional study was carried out at the DOTS-center of Nowshera Medical College / Qazi Hussain Ahmed Medical Complex Nowshera from 1st March to 31st October 2022 and comprised of 130 patients. In this study, Convenience sampling (Non probability) was used. The data was collected by a structured questionnaire and analyzed by statistical package for the social sciences (SPSS version 24). Quantitative data were described by measures of central tendencies; mean and standard deviation and qualitative data were described by frequencies and percentages. Chi-square test was used to test the relationship between variables where the level of statistical significant was set at P ≤ 0. 05. Results: Participants included mainly the study population of children aged 0-15 years, and the gender was equally split throughout boy 50% and girls 50%. A large percentage (69. 2%) were from low income earners’ homes, and 66. 9% of the respondents were from rural areas. Subjects’ Body Mass Index (BMI) varied from less than 18 to more than 25. Of special interest, 43. 8% of the children with TB had not been administered BCG vaccination. The source of infection, that is, contact with an adult TB patient, was reported in 43. 8% while the rest were in the 56. 2 % who had no such history. Conclusion: childhood TB in the population under study is significantly related with some factors namely; direct contact with TB patients, low economic status, crowded housing, poor ventilation and malnutrition