Background: Tuberculosis (TB) is a highly infectious disease caused by Mycobacterium tuberculosis. Nevertheless, the incidence of BTA smear-positive pulmonary TB cases is reported increasing yearly in Ponorogo Regency according to the data of BTA smear-positive pulmonary TB cases from 2011 to 2015 will decrease with cases of 276, 392, 378, 293 and 334, respectively. Therefore, the implementation of those government programs needs to be assessed on a regular basis to evaluate its success and at the same time it is of fully importance to predict the pulmonary tuberculosis cases in the next few years. As a result, government and healthcare networks will be able to prepare better program. Objective: this study aimed to analyze the predictive incidence of pulmonary TB disease in Ponorogo Regency from 2016 to 2020. Method: This quantitative descriptive study adopted trend-time-series-cross-section method. Analysis data used qudratic metod. R square is the highest on the quadratic method. The population and sample were all from the data of BTA smear-positive TB cases based on the patients’ age, gender, comorbidity and nutrision status between 2011 and 2015 in Ponorogo Regency. Result: the distribution of BTA smear-positive pulmonary TB cases from 2011 to 2015 tended to increase with the number of cases of 276, 392, 378, 293 and 334 respectively. Once predicted, cases of Pulmonary TB from 2016 to 2020 will decrease with cases of 299, 348, 366, 352 and 306, respectively. Conclusion: The incidence of BTA smear-positive pulmonary TB based on the patient’s age group, gender, comorbidity and nutritional status would likely to increase in Ponorogo Regency in the coming years.