Objective To analyze the influencing factors of recurrence after cure in 202 newly treated smear-positive pulmonary tuberculosis patients. Methods A total of 202 newly treated smear-positive pulmonary tuberculosis patients were selected from April 2017 to July 2019 in Puyang Fifth People's Hospital.After treatment,they were followed up for two years.The patients were divided into recurrent group (15 cases) and non-recurrent group (187 cases) according to whether they recurred.The general data such as gender,age,occupation,education level,and clinical data such as whether diabetes,low protein,and the amount of sputum smear bacteria at the first diagnosis were collected and compared between the two groups.Logistic regression model was used to analyze the risk factors of recurrence in patients with smear-positive pulmonary tuberculosis after treatment. Results The recurrence rate of 202 patients with smear-positive pulmonary tuberculosis was 7.43％ (15/202) after 2 years of cure.There were significant differences between the two groups in age,diabetes,time of sputum bacteria turning negative,residual cavity after drug withdrawal,and bacterial count of sputum smear at the first diagnosis (P<0.05).Logistic regression analysis showed that the patients were≥60 years old (OR=6.799,95％CI:2.847-16.239),complicated with diabetes (OR=4.622,95％CI:1.159-18.436),the time of sputum bacteria turning negative was≥3 months (OR=7.336,95％CI:3.622-14.858),residual cavities after drug withdrawal (OR=4.182,95％CI:4.182-17.031),and the amount of sputum smear bacteria at the first diagnosis was 2+(OR=5.526,95％CI:1.657-18.426),3+(OR=7.039,95％CI:3.522-14.067),4+(OR=9.979,95％CI:5.071-19.639),were the influencing factors of relapse after cure in the patients with smear-positive pulmonary tuberculosis. Conclusion There is a certain level of recurrence rate in the first treatment smear-positive pulmonary tuberculosis patients within 2 years after cure.The older the patients are,the combination of diabetes,the time of sputum bacteria turning negative,the residual cavity after drug withdrawal,and the amount of bacteria in the first diagnosis sputum smear are the factors that affect the recurrence of the first treatment smear-positive pulmonary tuberculosis patients after cure.