Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Meishan City, Sichuan Province from 2011 to 2024, so as to provide the evidence for optimizing regional PTB prevention and control strategies. Methods: Data on PTB cases in Meishan City from 2011 to 2024 were collected through the Tuberculosis Management Information System of China Disease Prevention and Control Information System. A descriptive epidemiological method was used to analyze the temporal, population, and regional distribution characteristics of PTB cases. The average annual percent change (AAPC) and annual percent change (APC) were used to analyze the trend in incidence of PTB in Meishan City from 2011 to 2024. Results: From 2011 to 2024, a total of 23 405 PTB cases were reported in Meishan City, with an average annual reported incidence of 58.21/105, showing an overall downward trend (AAPC=-3.132%, P<0.05). Specifically, a declining trend was observed from 2011 to 2014 (APC=-11.724%, P<0.05), no statistically significant change from 2014 to 2020 (APC=-1.773%, P>0.05), and an increasing trend from 2020 to 2024 (APC=7.493%, P<0.05). There were 16 881 male cases (72.13%) and 6 524 female cases (27.87%). The predominant group was aged 21-<60 years, with 12 527 cases (53.52%). The proportion of PTB cases in the ≥60 years group increased from 38.44% in 2011 to 63.26% in 2024, showing an upward trend (AAPC=4.672%, P<0.05). Farmers/migrant workers constituted the predominant occupational group, with 18 522 cases (79.14%). The proportion decreased from 81.80% in 2011 to 73.00% in 2024, showing a downward trend (AAPC=-0.745%, P<0.05). Renshou County and Dongpo District had the highest number of reported PTB cases, with 8 814 and 7 052 cases, accounting for 37.66% and 30.13%, respectively. The proportion of PTB cases in Renshou County decreased from 13.72% in 2011 to 5.27% in 2024, showing a downward trend (AAPC=-5.898%, P<0.05). Conclusions From 2011 to 2024, the overall incidence of PTB in Meishan City showed a downward trend. Males, the elderly, and farmers/migrant workers were high-risk population. Renshou County and Dongpo District were high-incidence areas.