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Background The risk factors for mild to moderate hemoptysis in patients with pulmonary tuberculosis (PTB) are not entirely clear. The objective of this study was to evaluate factors for their independent association with the occurrence of hemoptysis in patients with PTB. Design Cross-sectional study of adult patients newly diagnosed with microbiologically proven PTB in a New York City hospital. Patients were categorized into subjects with and without hemoptysis and compared via univariate analysis. Independent associations of variables with hemoptysis were estimated with multivariate logistic regression. Results Of 194 subjects with PTB, 44 (23%) had hemoptysis. In univariate analysis, subjects with hemoptysis were significantly younger (p=0.003) and more likely to be undocumented foreign-born (p=0.038) compared to subjects without hemoptysis. In multivariate analysis, only younger age was independently associated with hemoptysis. This association was significant for a continuous decrease in age per year, or per decade (ORadj 1.59; p=0.003). Conclusions Younger age is an independent risk factor for hemoptysis in PTB. It is conceivable that a stronger inflammatory response in younger compared to older age could contribute to pulmonary pathogenesis and injury in PTB.