Diagnosing tuberculosis is a challenge because of the complex nature of the bacteria. Recently,rnthe need for TB culture is growing due to the increasing demand for TB drug susceptibilityrntesting(DST) and due to the high incidence of TB/HIV co-infection, which faces a great deal ofrnmisdiagnosis. Even though there are a number of better culture technology systems, most ofrnthese technologies are not feasible and affordable for resource limited countries like Ethiopia.rnTherefore, resource limited countries mainly rely on available solid culture system forrnMycobacterium isolation and DST despite the fact, they are time consuming, costly and needrnstringent media preparation procedure. Thus, this study was aimed to assess the performance ofrn5% sheep blood agar media for the isolation and DST of M. tuberculosis complex. Blood agar isrnsimple to prepare, readily available, and cheap media. 107 clinical specimens were collectedrnfrom patients referred to EHNRI for TB culture. Specimens were liquefied and decontaminatedrnby N-acetyl L- cysteine sodium hydroxide method and cultured on Lowenstein-Jensen media,rnblood agar media and BACTEC MGIT 960 system. Species identification was done using CapillarnTB-Neo (TAUNS Laboratories Inc, Numazu, Japan). DST for M. tuberculosis complex isolates werernperformed using proportion method on LJ and blood agar media. From the total 107 specimensrncultured, 2 specimens with persistent contamination were excluded from analysis, and analysesrnwere done with the remaining 105 specimens. The sensitivity, specificity, PPV and NPV ofrnblood agar media was 98, 98.2, 98 and 98.2%, respectively, as compared to LJ media, whereasrnthe sensitivity, specificity, positive predictive value and negative predictive value of blood agarrnmedia were 87.2, 100, 100 and 87.2% respectively, when compared to MGIT. Mean time forrnculture positivity was 9.3, 17.3 and 22.7 days for MGIT, blood agar and LJ media, respectivelyrnand the difference was statistically significant (P< 0.0001). On the other hand, concordancernbetween blood agar media and LJ media for DST was, 97.7% for Isonizid, 100% for rifampin,rn90.7% for streptomycin and 97.7% for etambutol. The contamination rate was 5.1, 9.7 andrn14.8% for blood agar media, LJ media and MGIT, respectively. In conclusion, blood agar mediarnwas correlated well with LJ media both for the isolation and drug susceptibility testing of M.TBrnand it was faster than LJ media.rnKeywords: Blood agar media, Diagnosis, Drug susceptibility testing, Isolation, Tuberculosis