〔Abstract〕 Objective To analyze the incidence characteristics and trends in pulmonary tuberculosis in the Hotan prefecture, before and after the epidemic, and to provide a reference basis for the formulation and evaluation of tuberculosis prevention and control measures in the Hotan prefecture. Methods The Hotan prefecture's pulmonary tuberculosis incidence data was collected between 2015 and 2021. Joinpoint regression(JPR) model and Interrupted Time Series(ITS) model were established to explore the incidence trend of pulmonary tuberculosis, as well as the impact of COVID-19 prevention and control measures in Xinjiang on the incidence trend in Hotan, respectively. Furthermore, an analysis of variations in incidence among different age and gender subgroups was carried out. Results The results of the JPR model showed that from 2015 to 2021, the reported incidence rate of pulmonary tuberculosis in the Hotan prefecture initially increased and then decreased, with a turning point appearing in December 2018. The incidence rate in males was slightly higher than that in females, and the turning point and incidence trend were consistent with the overall trend. Among all age subgroups, those ≥60 age group had the highest incidence rate, with the trend also showing an initial increase followed by a decrease. A turning point in the incidence rate for the under 18 age group appeared in June 2021, yet the trend was not statistically significant(P>0.05). The turning points in the 19-59 age group and in those aged ≥60 were consistent with the overall trend. The results of the ITS model showed that the incidence rate of pulmonary tuberculosis in the Hotan prefecture significantly decreased since January 2020, dropping from 319.28 per 100 000 in 2019 to 155.88 per 100 000 in 2021, a decrease of 51.16% year-on-year, with a monthly average reduction of 0.049 per 100 000. Conclusion In 2018, Xinjiang province integrated tuberculosis screening into the universal health checkup for the entire population, which led to the identification of numerous cases of tuberculosis. In the Hotan prefecture, the reported incidence of pulmonary tuberculosis peaked in December 2018 and then started to decline. Under the impact of COVID-19 isolation measures in Xinjiang, the reported incidence rate showed a notable decrease starting in January 2020. Reiterating preventive measures and remaining watchful for the possible appearance of latent tuberculosis patients is crucial as the pandemic fades.