Abstract Background: Tuberculosis (TB) is a major airborne infectious disease in India. Use of face masks by TB patients is an effective source-control measure to reduce transmission. However, compliance remains suboptimal due to multiple sociocultural and knowledge-related factors. Objectives: To assess the proportion of face mask usage and identify determinants influencing mask-wearing behaviour among TB patients. Methods: A hospital-based cross-sectional study was conducted among 150 confirmed pulmonary TB patients attending Manorama Raje TB Hospital, Indore. Data were collected using a pre-tested structured questionnaire. Descriptive statistics and chi-square tests were applied using SPSS. A p-value <0.05 was considered statistically significant. Results: Only 28.7% of patients reported consistent mask use. Mask usage was significantly associated with higher education level (p<0.05) and good knowledge of TB transmission (p<0.01). Major reasons for non-compliance included discomfort (42%) and social stigma (28%). Conclusion: Mask usage among TB patients was low. Strengthening health education and addressing stigma are crucial to improve compliance and reduce TB transmission. Keywords: Tuberculosis, Face mask, Infection control, Cross-sectional study, India.