Objective To deeply understand the causes of delayed return to work among young and middle-aged pulmonary tuberculosis patients, and to provide reference for the development of supportive intervention strategies for these patients to return to work. Methods Semi-structured interviews with 10 medical staff and 16 young and middle-aged tuberculosis patients were conducted in pursuant to phenomenological design in a specialized hospital in Guangzhou from May to July 2023.Colaizzi seven-step analytical method was used to analyze the interview data. Results Three themes and seven sub-themes were extracted：stigmatization（a strong sense of shame, being treated differently at work, alienation from colleagues）, disease-related fear（persistent physical discomfort, fear of recurrence）, and lack of specialty-oriented education (lack of professional advice, lack of bringing science-to-the public initiative). Conclusion The phenomenon of delayed return to work is common in young and middle-aged patients with pulmonary tuberculosis. Psychological intervention and diversified support should be used to help these patient sreturn to work at an appropriate stage.