Objective To observe the effect and adverse reaction of fixed dose compound preparation in the treatment of pulmonary tuberculosis. Methods From 2014 to 2016, pulmonary tuberculosis patients found at the TB control clinic of Jixi county received national free anti tuberculosis fixed dose combination (FDC) treatment, and the changes of liver and kidney function, blood routine, sputum smear and chest X-ray before and after treatment were observed. Results After standard anti tuberculosis treatment, the sputum negative conversion rate of smear positive pulmonary tuberculosis patients was 100%, the cure rate was up to 95.92%, the treatment rate of smear negative patients was up to 97.25%, the total effective rate of chest lesions was 93.04%, and adverse reaction rate was 55.69%. Conclusion The treatment effect of using fixed dose combination therapy for patients with pulmonary tuberculosis is obvious, and has good treatment compliance.