Background & Objective: Pulmonary Tuberculosis (PTB) not only poses significant health challenges but also impacts physical activity, rehabilitation, and overall well-being. The diagnosis of PTB in a family can introduce psychosocial stress, disrupt daily routines, and reduce participation in physical activities, affecting both the patient and their family members. Family resilience plays a crucial role in the adaptation process, influencing recovery, adherence to physical rehabilitation, and overall functional health. This study applies McCubbin’s Resilience Model of Family Adjustment and Adaptation to analyze the factors influencing family resilience in newly diagnosed PTB patients and its impact on their physical recovery, social reintegration, and ability to engage in physical activities. Methods: A cross-sectional study was conducted with 237 patients and their families recruited through convenience sampling at Nanjing Public Health Medical Center between August 2022 and April 2023. The Chinese version of the Family Resilience Assessment Scale was used alongside other standardized indicators to evaluate resilience factors. Structural equation modeling (SEM) was employed to assess relationships among stigma, family burden of disease, individual resilience, internal and external support systems, and family function. The study also explored how these factors influence physical adaptation, rehabilitation, and engagement in physical activity. Results: A total of 251 questionnaires were distributed, yielding a 94.4% response rate, with 237 valid responses. Individual resilience, internal support systems, and family function were positively correlated with higher levels of family resilience. In contrast, stigma, family burden of disease, and external support systems showed indirect associations with resilience. Statistical analysis confirmed that individual resilience (coefficient: 0.605) and internal support systems (coefficient: 0.419) were the strongest predictors of family resilience (P < 0.05). Conclusions: The findings underscore the critical role of individual resilience and internal family support in facilitating adaptation to PTB, enabling better physical rehabilitation, adherence to treatment regimens, and reintegration into physical activity and daily routines. This study highlights the need for targeted interventions in sports and rehabilitation medicine to enhance mental and physical resilience in PTB patients and their families. By addressing stigma and promoting self-acceptance, families can create a supportive environment that encourages physical activity, social participation, and improved quality of life. Healthcare providers, sports therapists, and rehabilitation specialists should incorporate family resilience strategies into rehabilitation programs to ensure comprehensive recovery and long-term physical well-being for PTB patients.