Background: Pulmonary tuberculosis remains a public health problem because transmission may continue when patients do not consistently apply preventive practices. Although health education is commonly provided, evidence on structured behavioral education specifically targeting adherence to tuberculosis transmission-prevention practices remains limited, particularly in community-based tuberculosis services. Objective: This study aimed to assess changes in adherence to tuberculosis transmission prevention practices following structured behavioral education among pulmonary tuberculosis patients. Methods: A single-group pre–post quasi-experimental study was conducted among 44 pulmonary tuberculosis patients at the Community Lung Health Center of Ambon City. Participants were selected using purposive sampling. The intervention included structured education on tuberculosis transmission, mask use, cough etiquette, sputum disposal, environmental hygiene, home ventilation, and treatment adherence. Adherence was assessed using a structured questionnaire before the intervention and immediately after completion of the educational session; therefore, the post-test reflected short-term changes in adherence. Pre- and post-intervention scores were analyzed using the Wilcoxon signed-rank test. Results: The mean adherence score increased from 77.67 ± 13.93 before the intervention to 85.34 ± 10.66 after the intervention. The proportion of participants with good adherence increased from 21 participants (47.7%) to 32 participants (72.7%). The Wilcoxon signed-rank test showed a statistically significant difference in adherence before and after the intervention (p < 0.01). Conclusion: Adherence to tuberculosis transmission prevention practices improved following structured behavioral education. This intervention may be integrated into routine tuberculosis counseling in community lung health services.