Objective To analyze the adolescent tuberculosis reported in Haikou region between 2018 and 2021 and factors influencing the outcome. Methods The data on adolescent tuberculosis cases reported in Tuberculosis Information Management System in the Haikou Regional Centre for Disease Control and Prevention (RCDC) from 2018 to 2021 were collected. A follow-up survey was carried out until 31 December 2022. The changes in reported incidence of adolescent tuberculosis in Haikou was analyzed, and multivariate Cox proportional hazards regression models were used to identify independent factors influencing the outcome of adolescent tuberculosis. Results A total of 265 cases of tuberculosis in adolescents were reported between 2018 and 2021, of which 55 were reported in 2018, 74 in 2019, 67 in 2020, and 69 in 2021. The total number of reported cases of tuberculosis was 140 among male adolescents, which was slightly higher than 125 among female adolescents. The number of reported cases of tuberculosis was 134 in adolescents ≥15 years of age and 131 in adolescents <15 years of age. No statistically significant difference was reported between good outcome group and poor outcome group in age, gender, place of residence, nationality, and domicile place (P>0.05), whereas difference was found in the history of tuberculosis between two groups (P<0.05). Multivariate Cox proportional hazards regression model denoted that retreated tuberculosis (HR: 2.172, 95%CI: 1.483-3.007), complicating underlying disease (HR: 1.451, 95%CI: 1.080-1.985), and number of sputum smears (HR: 2.617, 95%CI: 1.531-3.458) were the risk factors for adverse outcomes in adolescent tuberculosis. Conclusion From 2018 to 2021, the number of reported adolescents of pulmonary tuberculosis in Haikou increased, suggesting that the management and prevention of adolescents should be strengthened to improve the prognosis rate of adolescents.