Abstract: Objective To evaluate the effect on drug-induced damage of liver in the patients with pulmonary tuberculosis and high risk factor of drug-induced damage of liver and its sputum smear negative conversion with interventions when anti-tuberculosis agent was given.Methods This retro-spective study included 300 patients collected from January 1, 2000 to March 31, 2009 in our hospital, who received initial treatment, with smear positive with pulmonary tuberculosis. Associated with high risk factor of damage of liver, 300 patients were randomly divided into two groups, 150 patients in the group with interventions, the other 150 patients in the other group without interventions when given ant-tuberculosis agent.Results There were only 15 patients associated with drug induced hepatitis in the group with interventions. However, 55 patients associated with drug induced hepatitis in the group without interventions when given anti-tuberculosis agent. The rate of drug induced hepatitis among the group with interventions was lower than that of group without interventions,which was a statistically significant difference (P<0.01). But the rate of sputum smear negative conversion after two months treatment were 63.3%(95/150) and 63.9%(96/150) between the two groups of patients,which was not a statistically significant difference (P>0.05). The rate of sputum smear negative conversion after treatment was finished were 93.3%(140/150) and 95.3%(143/150) between the two groups of patients. There were 86.0%(129/150) and 88.6%(133/150) patients with best or better X ray results respectively. The recurrence rate were 4.0%(6/150) and 3.33%(5/150) in the two groups of patients,which was not a statistically significant difference (P>0.05) after one year follow-up study.Conclusion Interventions should be performed in the patients with smear positive pulmonary tuberculosis associated with high risk factor of drug induced damage of liver,which can reduce the incidence of drug induced damage of liver,and secure the efficacy of anti-tuberculosis therapy.