Tuberculosis (TB) is a high risk in vulnerable groups with low immunity, such as children. Environmental factors and household contacts influence the high incidence of tuberculosis. This study aimed to determine the relationship between housing conditions and the presence of household contacts with the incidence of pulmonary tuberculosis in children. This study used a case-control design. The research location was at the Kedaton Public Health Center, Bandar Lampung, from December 2023 to January 2024. The study's sample number was 29 people in each case group and control group, so the total sample size was 58. The sampling technique used simple random sampling. The independent variables of this study were residential density, humidity, lighting, floor type, ventilation area, and the presence of household contacts. Meanwhile, the dependent variable was the incidence of pulmonary tuberculosis in children. This study used univariate analysis, bivariate analysis with chi-square, and multivariate with multiple logistic regression. This research shows that there is a relationship between lighting (p=0,008), ventilation area (p=0,032), and the presence of household contacts (p0,001) with the incidence of pulmonary TB in children, and there is no relationship between occupancy density (p=0,576) and humidity (p=0,230) with the incidence of pulmonary TB in children at our study area. The factor most associated with the incidence of pulmonary TB in children was lighting (OR=6,061; 95% CI=1,768-20,777). Lighting, ventilation area, and the presence of household contacts were associated with the incidence of pulmonary TB in children. Lighting is the factor most associated with the incidence of pulmonary TB in children in this present study.