Introduction: despite availability of reliable diagnostic approaches and effective drugs for overrndecades, Tb remained a major public health problem, where there have been limited impacts inrnreducing its global burden despite the growing adherence to the recommendations of WHO onrnthe use of DOTS and other interventions in many countries.rnObjective: to assess the quality of Tuberculosis treatment in Afar National Regional State.rnMethodology: cross sectional health institution based survey was conducted between 5thrnFebruary and 10th March in six health institutions, where records were reviewed for 270rnPatientsâ€™, exit interview were made among 209 patients, six providers were interviewed andrnobservations were made for 49 patients. Data were entered and analyzed using SPSS 11.0 forrnwindows statistical software and findings at 95% confidence interval and p value of 0.05 werernreported as statistically significant.rnResult: the results of the study showed that staffing qualities were poor and patterns ofrnsupervision were weak but delivery supplies for Tb control activities were good. A relativelyrnhigher proportion of patients were dissatisfied with the appropriateness and adequacy of workingrnhours and waiting time. Statistically significant correlation was observed between process qualityrnand output quality (clientsâ€™ satisfaction).rnConclusion And Recommendations: it was concluded that the quality of Tb treatment in AfarrnNational Regional State was poor where; both the quantity and the quality of staffing were notrnsatisfactory, the issue of refreshment training seems to be absent, the pattern of supervision wasrnweak and was also unplanned, inconsistent and lack feedback whenever it had been effected,rnwhich is totally against the national guideline where it is strongly recommended as part ofrnprogram communication. Hence, mechanisms to improve the different aspects of the programrnand sticking to the national TLCP manual were strongly recommended.rn2