The incidence of Tuberculosis (TB) in Guizhou province has ranked to be the top four among the 31 China provinces. The spatial distribution and influencing factors of adverse outcomes of TB in Guizhou are unclear. In our study, the cases information of TB in Guizhou province from 2013 to 2018 was collected, we analyzed the spatial distribution and clusters of five adverse outcomes of TB with ArcMap10.2 software, used logistics regression analysis to assessed risk factors and used Chi-square analysis to analyze variation trend of the five adverse outcomes. A total of 237, 806 cases information of TB were collected. The proportion of adverse outcomes in TB patients was 6.18%, among which adverse reactions accounted for 1.05%, lost to follow-up accounted for 1.44%, treatment failed accounted for 1.15%, died accounted for 2.31%, switch to MDR accounted for 0.24%. The component ratio of adverse outcomes showed an upward trend (P < 0.05).Regional clustering existed in each of adverse outcomes (P < 0.05). There were high-risk minorities, gender, age, occupation, type of diagnosis, Therapeutic category existed in adverse outcomes of TB. Miao and Dong had a higher risk in adverse reaction of TB compared with Han. Women had a higher risk in adverse reactions than men, and a lower risk of lost to follow-up, failed, and died. Retreated patients had a higher risk of adverse outcomes. Timely monitoring and active intervention should be carried out for some high-risk areas and groups, including middle-aged and elderly patients, rural patients, floating patients, severe patients and retreated patients during the process of patient diagnosis and treatment.