Background Tuberculosis in Egypt is a main public health problem. Egypt is categorized among the mid-level incidence countries. The objective of this work is to study the epidemiology of TB in Giza Governorate during the period from 2014 to 2018. Results This study revealed that the total number of TB cases in Giza Governorate during the period from 2014 to 2018 was 3357 (2035 males and 1322 females including 199 children) with the highest number of cases in 2017 (n=770 cases). The highest incidence occurred in the age group 18–65 years (86.3%%, 78.8%, 83.8%, 84.2%, and 87.1%) and male gender (56.8%, 62.8%, 59.9%, 61.3%, and 61.5%) during the study period, respectively, and in urban residence, the higher percentage occurred in PTB than EPTB in 2014, 2015, 2016, and 2018 (66.2%, 58.9%, 57.3%, and 55.5%), respectively, while the incidence of the extra PTB was higher than PTB in 2017 (51.6% versus 48.4%). The increased incidence of new cases (92.9%, 89.6%, 92.7%, 91.8%, and 92.9%) during the 5 studied years are smear-positive and cure outcome (86.3%, 87.7%, 88.7%, 83.4%, and 83.4%, respectively) Conclusion Young, middle-aged male, and new smear-positive cases were highest in percentage. The highest percentage of PTB (66.2%) was registered in 2014, and the highest percentage of EPTB (51.6%) was registered in 2017. The increased percentage of cure outcome was during the period from 2014 to 2018 in Giza Governorate.