Objective The aim of this work was to evaluate the Primary Health Care service performance in National Tuberculosis Control Program in Qalyubia Governorate. Methods The studied area (Qalyubia Governorate) includes 8 health territories (each contains 5 primary care units/centers). A questionnaire based on 6 parameters was used to evaluate the PHC system performance: I – Physicians with basic knowledge about TB (causative agent, methods of spread, clinical picture, essential steps in investigations: X-ray and sputum smear), II – Facilities for primary investigation (sputum examination and chest X-ray), III – Communication with the central health authorities or a TB specialist, IV – Proper recording systems needed for proper patient management and follow up, V – Follow up schedules are available for the detected patients, VI – Have a role in community education about the disease. The data obtained were tabulated and statistically analyzed. Results Studied area included 8 health territories and 40 primary care units (35% were urban and 65% rural) with one physician in each unit. The mean percent of the correct answers of the basic knowledge score was 48.2% (range = 18%–100%), higher in urban units physicians than rural units physicians, with lack of proper laboratory (for sputum analysis) or X-ray apparatus. Communication with central health authorities in urban areas was higher than rural areas (65.4% versus 57.1%). Case recording was lower in urban than rural areas (42.9% versus 46.2%). Patient follow up after referral to central health units was higher in rural than urban areas (11.5% versus 7.1%). Participation of community education was 78.6% in urban units and 76.9% in rural units. Conclusion In Qalyubia Governorate, PHC physicians lack proper knowledge about TB and their units lack proper equipments (Lab and CXR). The PHC system needs to be empowered by the health care authorities through training and equipments for better performance in NTP.