Pulmonary tuberculosis remains an important public health problem in Indonesia. Standard treatment with anti-tuberculosis drugs is the main component in reducing bacterial load and preventing transmission; however, nutritional support is also needed to assist patient recovery. Arsik Dali Ni Horbo is a traditional Batak local food made from buffalo milk and has the potential to serve as dietary support for tuberculosis patients. This study aimed to determine the difference in sputum acid-fast bacilli counts before and after the consumption of Arsik Dali Ni Horbo among pulmonary tuberculosis patients receiving standard therapy. This study used a quasi experimental design without a control group, using a one-group pretest-posttest approach. The sample consisted of 30 adult pulmonary tuberculosis patients diagnosed between September and December at UPT Puskesmas Helvetia, Medan City. The intervention consisted of consuming 100 grams of Arsik Dali Ni Horbo per serving, four times per week for one month. Acid fast bacilli data before and after the intervention were obtained through laboratory examinations. Data were analyzed using univariate and bivariate analyses, with a dependent t test performed after the data were confirmed to be normally distributed. The results showed that the mean AFB count before the intervention was 6.93 ± 1.51, while the mean AFB count after the intervention was 6.57 ± 1.19. The mean reduction in AFB count was 0.37, with a p-value of 0.046. This study showed a significant difference in AFB counts before and after the consumption of Arsik Dali Ni Horbo, although the magnitude of the reduction was relatively small.