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A Clean and Healthy Lifestyle can be primary prevention of pulmonary TB transmission that can be done in Islamic boarding schools. This study, analyzed the factors related to the practices of PHBS for preventing pulmonary TB on Islamic boarding school students in Tegal Regency. This quantitative research used cross-sectional study design. Population is all students as many as 886, with 268 sample using the Lemeshow calculation, proportion of sample is 130 male and 138 female students and used simple random sampling technique. Collecting data by filling out questionnaires. Analysis was performed by univariate, bivariate, using chi-square test with 95% significance, and multivariate using binary logistic regression test. This research has received approval from the ethics commission No: 90/EA/KEPK-FKM/2021. The results showed that 47% of respondents had poor PHBS behavior to prevent pulmonary TB. The related variables were gender (p=0.000), education level (p=0.028), knowledge (p=0.0002), attitude (p=0.000), availability of facilities (p=0.000), availability of information (p=0.000) ), access to health services (p = 0.000), regulations (p = 0.000), kyai attitudes and behavior (p = 0.000), teacher attitudes and behavior (p = 0.000), management attitudes and behavior (p = 0.000), friend's attitude and behavior (p=0.000). The unrelated variable was age (p=0.051). The most influenced variable was gender (OR = 5,815). The results of the study are expected to be the basis for Islamic boarding schools as educational institutions to improve the implementation of Clean and Healthy Behavior in preventing pulmonary TB transmission by increasing the performance of Poskestren and other components that support Islamic boarding schools both materially and socially for all students.