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Introduction: Tuberculosis (TB) is a chronic infectious disease that also causes lipid abnormalities. Limited studies are focusing on metabolic abnormalities in TB patients with Diabetes Mellitus (DM). While studying lipid abnormalities in pulmonary TB patients, there were no marked differences between serum levels of cholesterol, triglycerides, Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). However, it was suggested that increased levels of lipoprotein (a) in patients with pulmonary TB may be a risk for atherosclerosis. Aim: To study the lipid abnormalities in TB patients with DM. Materials and Methods: This cross-sectional study was conducted in Department of Pulmonary Medicine at a tertiary care teaching institute {PES Institute of Medical Sciences and Research (PESIMSR} Andhra Pradesh, India, between October 2015 to March 2016 (six months). Four groups were made, Group I included 30 patients with TB and no DM, Group II included 25 patients with TB with DM, Group III had 30 patients with DM only and Group IV was control group with 30 healthy individuals. Lipid profile testing was done for all the participants and the values obtained were compared. Analysis of Variance (ANOVA) test was used to compare the means between the groups and Kruskal-Wallis test when data did not follow the normal distribution. The p-value <0.05 was considered statistically significant. Results: Total 25 patients in group II had 18 male and 7 female with mean age of 48.5±11.12 years. The total cholesterol, triglycerides, Very Low Density Lipoprotein (VLDL) was high in group III (176.33±43.35 mg/dL, 221.733±39.2 mg/dL, 34.8±17.81 mg/dL respectively). The HDL was lowest in group II (27.88±8.03 mg/dL). However, the LDL values showed no significant difference between the groups (p-value=0.162). group I had Low Body Mass Index (BMI) (18.61±3.6 kg/m2). The atherogenic index was high in group II especially in males. Conclusion: In patients with TB and DM, screening of lipid profile can provide markers of atherogenicity which may help to predict and prevent cardiovascular events. A good nutritious diet is recommended alongside chemotherapeutics in the treatment for TB patient's management and their lipid profile status should be monitored while managing the patients. [ABSTRACT FROM AUTHOR]