Tuberculosis remains a major health problem worldwide in the era of HIV/AIDS. Co-infection with intestinal parasites has been suggested to worsen the outcome of infection in addition to HIV infection. Hence, adequate information on TB patients with HIV and intestinal parasites infection is being needed to tackle the problem, undertake the integrated prevention and control program. This study was aimed to assess the prevalence of HIV and intestinal parasitic infections in active pulmonary tuberculosis patients compared with their healthy extended family of the subject as a control. A case-control study was carried out from November, 2010 to June, 2011 in Woldia General Hospital and Woldia Health Center. Stool sample were examined using direct technique and formol-ether concentration techniques. Modified acid fast stain was used to identify Oocysts of Cryptosporidium species and Isospora belli. HIV rapid tests were used to screen sero prevalence and AFB smear microscopy for screening Pulmonary TB patients. A total of 100 smear positive TB patients and 168 familial contacts were participated and the overall prevalence of intestinal parasite among TB patients was 49%; compared to 23.2% of the control. 41% of TB patients and 23.8% controls were found to be HIV infected. Double infection with both intestinal parasite and HIV was found in 61% TB patients and 52.5% of the controls. The proportions of TB patients infected with 1, 2, or more species of worms were 73.5%, 26.5% respectively; 82%, 18% were in controls and the odds of being an active TB patient is increased with the number of species of intestinal parasites the person harbors. The current study showed that a significant association between TB/HIV infection and intestinal parasite particularly Strongyloides stercoralis Cryptosporidium parvum and Isospora belli.