Numerous investigations have documented active tuberculosis (TB) infection following biologic treatment. One of the most secure biologic medications for infections is secukinumab. Additionally, no cases of active TB while receiving secukinumab therapy were recorded. Secukinumab 150 mg per month has been administered for a 19-year-old man with spondyloarthritis since May 2020. A diagnosis of pulmonary TB was made when the patient complained of a moderate fever, a productive cough, and weight loss after 2 years. His fever and respiratory symptoms were relieved after 6 weeks of treatment by stopping secukinumab and utilizing 4 antibiotics: isoniazid, rifampicin, pyrazinamide, and ethambutol, while non-steroidal anti-inflammatory drugs reduced his joint and back discomfort. During biological therapy, even with secukinumab, annual screening for latent and active TB is crucial. We require additional study on secukinumab-treated patients with active TB in nations with high TB burdens, including Vietnam.