Tuberculosis is a huge problem, estimated to infect a third of all human population. It is especially stark in developing countries and expected to become more severe with the advent of MDR, XDR and TB-HIV. Unfortunately, as few newer drugs are in the pipeline, the logical way out is to focus on program management for its control. WHO has recommended DOTS guidelines for TB control in program conditions. These guidelines have been implemented in many countries of the world. However, DOTS has been fiercely criticized by some experts. This book examines the effectiveness of DOTS guidelines under the largest running TB control program in the world in India using the Systematic Review methodology. It attempts to explore the reasons for an abnormally high number of re-treatment (relapse, failure, default) cases. The evidence may have a phenomenal impact on the life of millions of people undergoing treatment for TB.