Abstract Background: Tuberculosis (TB) is a major cause of illness and death worldwide, especially in Asia and Africa. In the early 1990s tuberculosis control in Egypt faced many problems. Major progress in global tuberculosis control followed the widespread implementation of the DOTS strategy. Aim: The objective of this work was to study the tuberculosis situation in Port Said governorate from (1995–2011) before and after Direct Observed Therapy Short Course Strategy (DOTS). Methods: This was a retrospective clinical cohort study carried out at the Port Said governorate. The registered data about all TB cases over a period of 16 years (1995–2011) before and after the application of DOTS were collected from the chest hospital and TB registration units. Results: Percentages of cure and complete treatment significantly increased after DOTS (48.7% and 29.3% respectively) than before (19.5% and 13.7% respectively) (P