HIV testing among patients with tuberculosis is critical to preventing missed diagnosis of HIV, improving morbidity and mortality and ensuring continuum of care for HIV-TB co-infected patients. The objective was to determine the HIV test uptake and assess sexual risk behaviour among patients with pulmonary tuberculosis attending DOTS clinic in a tertiary hospital in Nigeria. The study also determined the HIV sero-prevalence and evaluated the HIV-TB co-infection pattern among these patients. Routine HIV counseling and testing was offered to consecutive patients with pulmonary tuberculosis attending DOTS clinic between January 2008 and December 2010. Those who accepted to be tested and also consented to the study were interviewed using a pre-tested questionnaire. A total of 301 patients with pulmonary tuberculosis were seen in the DOTS clinic between January 2008 and December 2010. Two hundred and fifty two (83.74%) were tested for HIV and 19.84% of those tested were positive. Smear positive and smear negative patients were responsible for 2.78% and 17.06% of HIV prevalence respectively. 38.8%, 21.7% and 0% missed HIV test in 2008, 2009 and 2010 respectively. Only 30% of the patients used condom with sexual partners and 25% reported having multiple sexual partners. The study showed that HIV test uptake among patients with pulmonary tuberculosis was high and progressively increased from 2008 to 2010. It also revealed an HIV sero-prevalence of 19.8%. There is need to improve on the integration of HIV-TB services so that more patients with tuberculosis will access HIV counseling and testing and for effective continuum of care to reduce morbidity and mortality among those co-infected.