To compare serum vitamin D and calcium levels between tuberculosis (TB) patients and age-matched and sex-matched healthy controls, and to evaluate their relationship with disease severity.

Comparative cross-sectional study.

Dilla University Teaching Hospital (DUTH), Southern Ethiopia.

100 adult TB patients and 100 age-matched and sex-matched healthy controls aged 18 years or over.

Serum 25-hydroxyvitamin D [25(OH)D] and calcium levels.

Mean serum vitamin D was markedly lower in TB patients than in controls (21.4±7.3 ng/mL vs 32.0±6.6 ng/mL; p

Low vitamin D and calcium levels were observed among TB patients in Southern Ethiopia. These findings emphasise the need for routine micronutrient screening and considering supplementation in TB care. Further research is needed to clarify the clinical significance of these micronutrient levels in TB management.