Tuberculosis is one of the main causes of death worldwide. This study aimed to determine predictive factors for death in patients with tuberculosis to set priorities for public heath interventions to reduce mortality in these patients. This nested case–control study was carried out in Mazandaran province of Islamic Republic of Iran among tuberculosis patients who were treated during 2002–2009. Each deceased patient was individually matched with a control patient according to sex, age, area of involvement and time of follow-up. Potential risk factors for death were evaluated using multivariate conditional logistic regression models. From 2206 patients 376 cases and 376 matched controls were selected. Only positive serology for HIV (OR = 19.1), history of kidney disease (OR = 6.81) and use of immunosuppressant drugs (OR = 3.96) significantly increased the risk of death in tuberculosis patients. These potentially modifiable risk factors could be taken into account in preventive interventions for tuberculosis patients in our country.