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Background Tuberculosis (TB) has long been associated with negative attitudes among people as a contagious, incurable and emaciating disorder. This study aimed to assess the prevalence of stigma towards tuberculosis, among patients with pulmonary tuberculosis. Methods A descriptive cross-sectional study was carried out at the Chest Clinic, Matara among 116 smear positive pulmonary tuberculosis patients. Self-administered questionnaire and indepth interviews were carried out to collect data and multiple variables were analyzed. Results Of the 116 patients 62(53%) were male and 54(47%) were female. Sixty (52%) were employed. Mean age was 47.84 years and age range 12-89 years. Analysis of education level indicated that 2(1.7%) had pre-primary, 49(42.2%) primary, 48(41.4%) lower secondary level, 15(12.9%) upper secondary and two (1.8%) post-secondary education. The four categories of stigma; external stigma, internalized stigma, anticipated stigma and courtesy stigma were assessed. With regard to external stigma, 68 (58.6%) were reluctant to investigate close contacts, 10(16%) lost their jobs and in two (16%), partners refused to marry. With regard to internalized stigma, 82 (70.7%) were reluctant to obtain direct observer treatment from a person in the village and 74(64%) had had a mental setback. In anticipated stigma, 94(81%) maintained a distance when talking to others and 89 (76.7%) were reluctant to disclose their status to persons other than close family members. Conclusion This study shows stigmatization towards the disease in many aspects. Findings could be utilized to implement multidimensional stigma mitigation interventions including advocacy programs, social mobilization and individual behavioural therapy. .