Abstract: Delay treatment of Pulmonary Tuberculosis (PTB) caused severe disease and higher mortality. It also leads to an increased period of infectivity and transmission in the community. The objectives of this study were to, identify time of delays, duration from the appearance of first symptom of the disease until date of initial treatment (Total Delay: TTD), duration from the appearance of first symptom of the disease until first contact health workers (Patient Delay: PTD) and duration of first contact health workers until date of initial treatment (Health System Delay: HSD), identify factors predicting delay of treatment among new-smear positive pulmonary tuberculosis patients in Thai-Cambodia border. A cross-sectional analytical studied new smear-positive pulmonary tuberculosis patients in Thai-Cambodia border over a 2 year period. Patients were interviewed on entry, reporting the duration of symptoms before the start of treatment and start of contact health provider for initial treatment to be collected. Questionnaires were collected by sixteen well-trained assistant researchers by explaining the purposes of study. It was decided that 60 days was an acceptable total delay. Associations were investigated using univariable and multivariable analysis and the population attribute 443 subjects from 8 hospital public health centers in Thai-Cambodia border were estimated. Of 443 patients, 74.04% had a delay of PTD >28 days (med = 51, Q1 = 28, Q3 = 98), 25.51% had a delay of HSD >14 days (median day = 4, Q1 = 0, Q3 = 16) and 53.72% had delay of TTD >56 days (median day = 62, Q1 = 31, Q3 = 112). It found that 7 factors correlated with patient delay. The best predictor was cough with sputum (56.2%), cough with no sputum (15.33%), cough with hemoptysis (5.4%), chest pain (13.5%), fever (8.8%), loss weight >10% (4.1%) and pay for travel (3.1%) correlated with patient delay (R² = 0.64, p<0.05). It found that 6 factors were correlated with health system delay. The best predictor was other first symptom (53.5%), first diagnostic (13.8%), television perception (9.5%), first contact private hospital (10.1%), border travel (7.1%) and doubt of TB and none practice (5.9%), respectively (R² = 0.168, p<0.05).