Objective To analyze the results of tuberculosis screening and the characteristics of detected cases in freshmen entrance physical examination in Anhui Province from 2022 to 2024, and to provide theoretical basis for optimizing screening strategies. Methods Data of tuberculosis screening for freshmen in Anhui Province from 2022 to 2024 were collected. Descriptive epidemiological method was used to analyze the temporal, population, and regional distributions of relevant indicators, as well as differences in screening methods. Results A total of 9 203 416 freshmen were screened in Anhui Province from 2022 to 2024, and the screening rate was 98.57%. A total of 283 cases of pulmonary tuberculosis were detected, with a detection rate of 3.07/100 000. The abnormal screening rate increased year by year (0.51%, 0.60%, 0.79%, respectively). The highest abnormal tuberculosis screening rate was observed in northern Anhui (0.86%), and the highest detection rate was found in freshmen in junior colleges/universities and above (8.35/100 000). Among different screening methods, the tuberculosis detection rate was the highest (1.96%) among individuals with abnormal chest X-ray screening results. The detected cases were mainly in the 13-18 years old (69.26%), 42.76% of cases were pathogen-positive, and 2.83% of cases were rifampicin-resistant. Conclusion The screening rate of tuberculosis for freshmen in Anhui Province from 2022 to 2024 is relatively high, but the abnormal screening rate shows an increasing trend year by year, and there are population and regional differences in screening results. Chest X-ray screening has a prominent case detection efficiency. Detected cases are mainly freshmen in middle school and junior college/university and above, and some cases exist drug resistance. It is necessary to optimize screening strategies for key populations and regions, and to strengthen pathogenic detection and drug resistance monitoring.