Background: TB is the number one killer infectious disease in developing countries. In 1990 World Health Organization (WHO) report on the Global Burden of Disease ranked TB as the seventh most morbidity-causing disease in the world and expected it to continue in the same position up to 20201.DOTS as the most systematic and cost-effective approach to revitalize the TB control programme in India has been formulated.Non adherence is found to be the major problem in DOTS therapy. Objectives:1)To study the socio-demographic factors of the study population. 2) To compare reasons for non-adherence/non compliance to DOTS in Tribal TB unit (TU) of Dhammapeta and TB unit (TU) of Nandigama (rural TB unit). Study design: The present study is an observational, prospective and community based study. Study population: All newly diagnosed sputum smear positive TB cases under DOTS- Strategy were selected The study population consisted of 174 in rural area and 107 in tribal area. Study period: The study was conducted from 01.04.2006 to 31.04.2007 (including follow-up). Results: In the age group of 15-49 years, the treatment interruption was more in the tribal area (70.73%) when compared to rural area (64.96%). In rural areas the most common factors for non adherence is adverse effects (40.24%), lack of personal interest (31.70%) followed by work load (30.48%).In tribal area the most common factors for non adherence is adverse effects (37.60%), work load (25.64%) followed by lack of personal interest (24.78%). Conclusion: the present RNTCP should develop Information, Education, and Communication package for the target group of patients.