Objective: To determine the prevalence of and factors associated with pulmonary tuberculosis (PTB) in an urban prison in sub-Saharan Africa. Design: A cross-sectional survey. Setting: The Central Prison of Douala, Cameroon. Results: Two thousand four hundred and seventy four (87.4%) out of 2830 inmates underwent screening. Twenty seven (1.1%) of the inmates were under treatment for smear-positive PTB on commencement of the survey while 60 (2.4%) were diagnosed with smear and/or culture-positive PTB during the active case finding, resulting in a point prevalence of PTB of 3.5%. HIV seroprevalence in inmates without clinical signs of PTB was 111/1067 (10.4%) while it amounted to 6/24 (25%) in PTB patients. In multiple stepwise regression analysis, a low BMl, a prison stay of ≤12 months, and a history of previous incarceration were positively associated with PTB. Conclusion: The study results confirm the high prevalence rates of PTB in prison populations and underscore the need for urgent preventive measures.