Objective: To investigate the epidemiological factors associated with extra pulmonary tuberculosis (EPTB) in Kassala, Eastern Sudan. Methods: Patients infected with TB (pulmonary and extra-pulmonary) documented at the hospital were interviewed with a structured questionnaire used to gather sociodemographic information. The diagnosis of EPTB cases was based on presence of tuberculous granulomas in the histological samples, positive PCR to DNA of mycobacterium tuberculosis, radiological findings and fluid analysis suggestive of EPTB and clinical diagnosis with adequate response to anti-tuberculous therapy. Results: A total of 985 patients with TB were enrolled in the study, including 761 (77.3%) with PTB and 224 (22.7%) with EPTB. The mean age (SD) of patients with PTB and EPTB was 33.2 (15.4) and 34.7 (14.6) years respectively. The prevalence of EPTB was at (22.7%), with TB lymphadenitis 79 (35.3%), marking the frequent form of EPTB followed by peritoneal TB 27 (12.05%). While residence and occupation were not associated with EPTB, those with lower level of education (OR = 0.3; confidence intervals (CI) = 0.2-0.5; P < 0.001), female (OR = 8.7, CI = 4.9-15.1, P < 0.001), non vaccination (OR = 70.3, CI = 34.2-144.3, P < 0.001), and non smoker (OR = 0.1; CI = 0.06-0.20; P < 0.001), were associated with high prevalence of EPTB. Conclusions: Around one quarter of patients with TB in this study were more likely to have EPTB. Therefore, effective strategic plans regarding diagnostic procedures and control measures are needed to reduce the burden of the disease in Sudan.