We performed a prospective clinical audit in hospitalised patients with suspected pulmonary tuberculosis (PTB) with the objective of evaluating the accuracy and clinical utility of Xpert® MTB/RIF in induced sputum in an intermediate-burden setting. Of 450 patients audited, 61 (13.6%) were diagnosed with PTB based on positive culture. The sensitivity, specificity and positive and negative predictive values for Xpert in smear-negative cases for induced sputum were respectively 75%, 99.5%, 94.7% and 97.0%. Xpert in induced sputum may facilitate diagnostic yield and expedite treatment in up to a quarter of PTB patients.