Phlegm smear testing for acid-fast bacilli (AFB) requires careful examination of tubercle bacilli under a microscope to distinguish between positive and negative findings. The biggest weakness of this method is the visual limitations of the examiners. It is also time-consuming, and mistakes may easily occur. This paper proposes a method of identifying tubercle bacilli that uses a computer instead of a human. To address the challenges of AFB testing, this study designs and investigates image systems that can be used to identify tubercle bacilli. The proposed system uses an electronic microscope to capture digital images that are then processed through feature extraction, image segmentation, image recognition, and neural networks to analyze tubercle bacilli. The proposed system can detect the amount of tubercle bacilli and find their locations. This paper analyzes 184 tubercle bacilli images. Fifty images are used to train the artificial neural network, and the rest are used for testing. The proposed system has a 95.6% successful identification rate, and only takes 0.8 seconds to identify an image.