Background <p>Tuberculosis retreatment is a major challenge in Ethiopia. Notwithstanding its considerable ramifications, there is a paucity of empirical evidence concerning the phenomenon of tuberculosis retreatment in highly populated city, Addis Ababa. Thus, this study aimed to determine the magnitude of tuberculosis retreatment and its determinants among tuberculosis patients receiving care at selected public health institutions in Addis Ababa, Ethiopia.</p> Methods <p>A five-year (from July 2017 to 7th July 2022) retrospective chart review of 876&#xa0;TB patients’ registers was conducted in 12 public health centers in Addis Ababa. The data were meticulously coded and inputted using Epi-Data version 3.0 and subsequently analyzed using SPSS version 26. A multivariable binary logistic regression model was employed to ascertain the relationship between dependent and independent variables. The results are presented using a combination of narrative descriptions, tabular formats, and graphical representations.</p> Findings <p>The prevalence of tuberculosis retreatment was 20.1% (95% CI: 16.75–23.0). Patients who were male (AOR = 1.68; 95% CI: 1.04–2.71), had a body weight below 50&#xa0;kg at enrollment (AOR = 5.56; 95% CI: 3.04–10.18) had a significantly higher odds of requiring tuberculosis retreatment. In contrast, individuals aged 15–29 years (AOR = 0.23; 95% CI: 0.15–0.37) and those with a normal body mass index (AOR = 0.12; 95% CI: 0.06–0.26) exhibited a lower odds of developing tuberculosis retreatment.</p> Interpretation <p>Higher retreatment rates among underweight patients and males underscore the importance of integrating nutritional assessment and gender-responsive interventions into TB programs. Conversely, younger age and individuals with a normative body mass index appeared to have reduced odds. Early nutritional and gender-specific strategies within tuberculosis treatment programs can mitigate retreatment and enhance patient outcomes.</p> Clinical trial number <p>Not applicable.</p>