Introduction: Although antiretroviral therapy (ART) leads to reduced tuberculosis (TB) incidence in people with HIV (PWH), ART recipients remain at higher risk of TB compared to HIV-seronegative people. With accelerated ART rollout in sub-Saharan Africa, increasing proportions of TB cases among PWH might occur in people receiving long-term ART. We determined TB notification rates among PWH by ART status in an urban area in Central Ethiopia 2015–2022. Methods: PWH were identified at health facilities providing ART 2015–2022. TB notification rates were compared by calendar year. PWH with TB were categorized by ART status at the time of TB diagnosis (pre-ART TB: TB diagnosed before or ≤ 6 months after starting ART; ART-associated TB: TB diagnosed > 6 months after starting ART). Results: Among 8,926 PWH, 993 had been diagnosed with TB (11.1%); 53.5% men, mean age 40.0 years [SD 11.8]). The number of PWH with TB remained relatively constant over time (annual mean 131 TB cases). Overall, 617/993 (62.1%) cases were pre-ART TB. The proportion of pre-ART TB remained relatively constant over time. Conclusion: TB notification rates among PWH did not decrease 2015–2022, with cases of pre-ART TB constituting a majority throughout the study period, implying persistently high TB incidence among PWH.