Objective:To analyze the economic burden of tuberculosis patients in areas with different economic levels, and to explore factors related to their economic burden. Methods: Two counties from Jiangsu Province, Zhangjiagang and Taixing, were selected as the study sites. Tuberculosis patients who had already completed the standard anti－tuberculosis treatment from 2010 to 2013 were recruited as the study subjects. Direct and indirect costs due to the disease were collected and compared between these two areas. Results: A total of 590 patients who had completed the survey were involved in the analysis, including 274 cases from Zhangjiagang and 316 cases from Taixing. The average total costs were 18 793.3 (median: 9 965.0) CNY for patients in Zhangjiagang and 6 598.3 (median: 2 263.0) CNY for patients in Taixing, respectively. The difference of costs between these two areas was significant (Z = 10.42, P < 0.001). In Zhangjiagang, the per capita out－of－pocket direct cost was 7 448.0 CNY and the per capita indirect cost was 6 856.4 CNY. In Taixing, the per capita out－of－pocket direct cost was 3 024.0 CNY and the per capita indirect cost was 2 615.2 CNY. Factors related to the out－of－pocket direct costs were migrant population, diagnosis delay, hospitalization, taking liver protective drugs and using the second－line drugs in Zhangjiagang, etc, and adverse drug reactions, abnormal liver function, diagnosis delay, hospitalization, taking liver protective drugs and using the second－line drugs, etc, in Taixing. Conclusion: Although the government provides free－service policy for tuberculosis, patients still need to bear a high economic burden, especially in economically developed areas.