Background: TB is an infectious disease mostly caused by the bacillus Mycobacterium tuberculosis. TB ranks alongside HIV/AIDS as a leading cause of death worldwide. However, the chances of developing TB is much higher in PLWHAs and tuberculosis becomes the most common opportunistic infection and commonest causative of death in PLWHAs. Broad objective: To determine prevalence and risk factors associated with mycobacterial TB disease among HIV-infected women in Moshi Municipal. Methodology: A cross sectional study on 146 HIV-infected women was conducted from January 2014 to December 2014. Demographic characteristics and other variables was collected using information available in the patients file from CTC clinics at Majengo and Pasua health centers in Moshi Municipal. The results of the study was analyzed with bivariate and multivariate analysis and cross tabulating the desired variables, logistic regression was also used to examine association between dependent variables and independent (explanatory) variables using fishers exact p-value, a Pearson Fishers exact p-value of <0.05 was used as a measure of association. Results: The prevalence of tuberculosis among HIV positive women was 5/146(3.4%). Socio-demographic variables such as age, marital status, residence, occupational status, ART use, CD4 count, attendance to the clinic and adherence to ART use of the participants were not statistical significantly associated with pulmonary mycobacterial tuberculosis disease in this study. Conclusion: The prevalence of pulmonary mycobacterial Tuberculosis disease is low among HIV women patients. Despite the fact that HIV patients are using ARTs and given TB prophylaxis after once diagnosed they are HIV positive but TB disease still continues to occur. Therefore more strategic preventive measures that will enhance body immunity are highly emphasized among HIV patients as early as possible before they develop active mycobacterial TB diseases in order to reduce the incidence and prevalence of mycobacterial TB disease to a negligible level.