Healthy indoor air environment quality is needed for healthy building hospital. Mycobacterium tuberculosis (MTB) is a microbial infectious agent which causes tuberculosis (TB) disease in human. Hence, health care workers (HCWs) are belonged to a highly potential risk group to be infected by MTB. This research aims to investigate the source and factor(s) of TB transmission in sustainable indoor air environment at the Hospital Sultanah Aminah Johor Bahru (HSAJB), Malaysia. The view taken in this paper is that the transmission dynamic of MTB from an active pulmonary TB (PTB) patient to another person via indoor air environment in the health care setting is generated as a result of an interaction between architect, building planner and owner, design and facility engineer, construction engineer, occupational health and safety professionals, hospital and HCWs, epidemiologist and public health officer. The findings were obtained by combining questionnaire and interview approaches using five ordinal measures of agreement using Likert Scale measurement. Analysis of qualitative data found that the source of MTB transmission was coming from active PTB patients especially those with sputum smear positive (SS+). The studied ambient parameters and factors affecting indoor air environment sustainability were thermal comfort, humidity, air pressure, temperature, duration exposure, area and volume, direction of air flow, lighting, air circulation exchange and MTB density in the air.