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This study investigates the moderating role of social support in the relationship between health empowerment and quality of life among elderly pulmonary tuberculosis patients in mainland China, utilizing the Johnson-Neyman (J-N) technique to identify the specific conditions under which this moderation occurs. A convenience sampling approach was employed to recruit 451 elderly pulmonary tuberculosis patients from the Department of Tuberculosis at Anhui Chest Hospital. Data collection took place between June 2023 and December 2023. Key variables were measured using established instruments: the health empowerment scale, the perceived social support scale, and the SF-36 quality of life scale. Statistical analysis included Pearson correlation to assess relationships between variables and J-N moderation analysis to explore the moderating effect of social support. Positive correlations were found between both health empowerment and social support with patients' total quality of life, physical component scores, and mental component scores. The J-N moderation analysis revealed a significant, non-linear moderating effect of social support on the relationship between health empowerment and quality of life. Specifically, at lower levels of social support, health empowerment demonstrated a positive association with quality of life. However, as social support levels increased, this positive relationship weakened. Furthermore, at high levels of social support, the relationship between health empowerment and quality of life turned negative, suggesting that excessive social support might mitigate the beneficial impact of health empowerment. Social support plays a complex and crucial non-linear moderating role in the relationship between health empowerment and quality of life among elderly pulmonary tuberculosis patients. While beneficial at moderate levels, excessive social support can paradoxically diminish the positive effects of health empowerment on quality of life. These results highlight the necessity of designing personalized and balanced intervention strategies that not only foster patient empowerment but also provide an optimal, rather than overwhelming, level of social support to maximize the quality of life for elderly pulmonary tuberculosis patients.