Objective To analyze the incidence trend and epidemiological characteristics of pulmonary tuberculosis (PTB) among healthcare workers (HCWs) in Chongqing City from 2019 to 2023, and provide reference for the prevention and control of tuberculosis among HCWs. Methods The registered data of PTB cases in Chongqing from 2019 to 2023 were collected from China Information System for Disease Prevention and Control. The three-dimensional distribution of registration rate, changing trend, and treatment characteristics of PTB among HCWs were analyzed using retrospective descriptive analysis method. Results A total of 646 HCWs PTB cases were registered in Chongqing from 2019 to 2023, and the average annual registration rate was higher than that of the entire population (52.34/100 000 vs 46.00/100 000). The registration rate in 2019-2023 showed an overall downward trend. The average annual registration rate of PTB among HCWs in hospitals was the highest (59.87/100 000), followed by primary medical institutions (41.62/100 000) and other medical institutions (35.21/100 000). The epidemic period of PTB among HCWs was March-June each year, with seasonal indices of 133.75%, 100.31%, 113.31%, and 117.03%, respectively. The average annual registration rate of PTB among HCWs in the southeast town of Chongqing was the highest (121.21/100 000), followed by the northeast town of Chongqing (89.51/100 000), while the lowest was in the main urban area (34.47/100 000). The registration rate of PTB among HCWs gradually decreased with the increase of age (P＜0.05). Compared with the whole population, the proportions of female PTB cases among HCWs (76.01%), 25-＜35 age group (57.89%), pathogen negative (48.14%), active detected cases (5.73%), initial treatment cases (95.82%), and cases using fixed-dose combination of PTB (74.15%) were all higher (all P<0.05). The delay rate of seeking medical treatment was lower in HCWs than that in the entire population (52.63% vs 69.12%), and the success rate of treatment was higher (91.49% vs 84.19%) (both P<0.05). Conclusion The registration rate of PTB among HCWs in Chongqing has been declining year by year, with diffe-rential distribution in different medical institutions and regions, presenting seasonal changes. The majority of cases are aged <35 years old, and have high pathogen negative rate and high initial treatment rate. Targeted prevention and control strategies need to be developed based on occupational exposure characteristics.