Background Tuberculosis (TB) continues to be a health problem in both developed and developing countries, including Ethiopia. Objective In this study, the prevalence of smear-positive tuberculosis among presumptive TB cases who visited the hospital was assessed. Method Acid fast bacilli (AFB) test was performed on samples collected from 200 presumptive TB cases. Data were analyzed using appropriate statistical tools. Result Among 200 presumptive TB cases, 10% (20 individuals) (60% were male and 40% were female) were found to be positive for the AFB. Of these AFB positive subjects, 11.2% and 6.3% were from urban and rural areas, respectively. Among 20 AFB positive cases, 45% (9), 45% (9), and 10% (2) were HIV positive, HIV negative, and with HIV status unknown, respectively. The highest AFB positive cases were found within age group between 25 and 44 years (70%) and followed by age above 40 years (30%). It was found out that 75% (15), 15% (3), 5% (1), and 5% (1) were unemployed, government employed, student, and nongovernment employed, accordingly. Conclusion This study indicated higher level of AFB positive cases within age groups of 25–44 and 65–74 years and also exhibited higher prevalence of TB cases from urban areas.