Objective: The study was to determine the influence of self-management counseling on self-efficacy in relation to the health-seeking behavior of patients with pulmonary TB at top referral hospital in West Java. Method: A quasi-experimental design, involving a pre- and post-assessment, was applied. Purposive sampling was used to select an intervention (n = 30) and control group (n = 30). Results: Self-management counseling was associated with an improvement in self-efficacy in relation to the health-seeking behavior and treatment adherence of patients with pulmonary TB (a mean increase in self-efficacy of 6.60 point) (p-value = 0.001). Conclusion: Self-management counseling significantly increased self-efficacy in relation to the health-seeking behavior and treatment adherence of pulmonary TB patients. Self-management counseling is recommended as a nursing intervention for pulmonary TB patients, especially in the early phase of treatment (i.e., the first 1–2 months) during the administration of medication at primary and secondary healthcare facilities. © 2019 Elsevier España, S.L.U.