Background and purpose: Tuberculosis (TB) is one of the main medical and health problems worldwide. Herein, we aimed to evaluate the effect of environmental factors on the incidence of this disease. In so doing, we can determine the critical and deficient areas, the risk factors for the disease, and implement preventive and therapeutic interventions.

Materials and methods: In this retrospective, descriptive-analytic study we used available information in health centers in Mashhad, Iran. Personal, demographic, environmental, and geographic data was the main basis of our study to identify the high-risk areas.

Results: We studied 813 patients diagnosed with TB in Mashhad health centers of Mashhad and its outskirts. The results showed significant relationship between the developing TB and nationality (P<0.05). Also, there was an association between risk of developing TB and living near major traffic arteries, areas with livestock farms or without waste collection system (P<0.05). The city's outskirts were determined as critical areas that need further considerations by health authorities.

Conclusion: Given the increasing incidence rate of TB in Iran, particularly in Mashhad, and escalated TB mortality, identifying factors causing the disease, especially the environmental and demographic factors, can improve management of this disease.