Background: Pulmonary tuberculosis (PTB) remains a major public health challenge in India, contributing to a substantial proportion of the global TB burden. Understanding the clinical and radiological spectrum of newly diagnosed PTB is essential for early diagnosis and effective management. Objective: To study the clinical and radiological profile of newly diagnosed pulmonary tuberculosis patients attending a tertiary care hospital in South India. Methods: This hospital-based descriptive cross-sectional study was conducted in the Department of Pulmonary Medicine at a tertiary care hospital in South India from November 2019 to January 2020. A total of 36 newly diagnosed, sputum-positive or CBNAAT-positive pulmonary TB patients aged ≥18 years were included. Detailed clinical history, physical examination, and chest radiography findings were recorded and analyzed. Results: The majority of patients were males (69.4%) with a mean age of 42.3 ± 14.6 years. Cough (94.4%), fever (77.8%), and weight loss (72.2%) were the most common symptoms. Radiologically, consolidation (66.7%) and cavitation (52.8%) were the predominant patterns, with the upper lobe being the most frequently involved zone (63.9%). Conclusion: Newly diagnosed PTB in this region predominantly affects middle-aged males and presents with classical symptoms of cough, fever, and weight loss. Chest X-ray remains a valuable tool, most commonly showing consolidation and cavitary lesions in the upper lobes.