Background: Tuberculosis is the most frequent life-threatening opportunistic infection and a rnleading cause of death among HIV infected people. Tuberculosis increases HIV replicationrnthrough the process of immune activation leading to increased viral load. rnObjective: To assess the risk factors of active Tuberculosis among People living with HIV onrnART follow upat Harargovernment hospitals, Ethiopia, 2019. rnMethodology: An institutional based case control study was conducted from March 13 to Aprilrn15, at Harar government hospitals, Ethiopia, 2019using pre-tested, validated, structuredrninterviewer-administered questionnaire and total of 301 participants responded. The Studyrnparticipants were selected by simple random sampling technique after proportional allocation ofrnsamples to the hospitals. Furthermore, descriptive statistics, binary and multivariable logisticrnregression analyses were employed to assess factors associated with active tuberculosis amongrnpeople living with HIV. rnResults:Out of 321 participants a total of 301 responded 101 cases and 200 controls. Afterrnadjustment for potential confounders, CD4 200-499 (AOR=7.15,95% CI:2.71-18.84), being rnsingle (AOR=4.47, 95% CI:1.04-19.27), BMI