(1) Background: Tuberculosis (TB) is a public health problem worldwide, and the influence of meteorological and air pollutants on the incidence of tuberculosis has been attracting interest from researchers. We will identify meteorological factors and air pollution factors that may affect the incidence of pulmonary tuberculosis (PTB); (2) Methods: We collected data on the daily incidence of pulmonary tuberculosis, meteorological data, and air pollutant concentrations in Changde City from January 1, 2010, to December 31, 2021. We analyzed the association between the incidence of PTB and meteorological factors and air pollutants and further explored the distributed lag non-linear effect of meteorological factors and air pollutants on the incidence of PTB using a distributed lag non-linear model (3). Results: The incidence of tuberculosis was positively correlated with mean air temperature, maximum air temperature, minimum air temperature, sunshine hours, PM2.5, PM10, and O3, and negatively correlated with mean air pressure, relative humidity, precipitation, CO, and SO2, but not significantly correlated with mean wind speed and NO2 (4). Conclusions: Meteorology and air pollutants have certain effects on the incidence of pulmonary tuberculosis, and the impact will also have a lag effect.