We conducted a cohort analysis of all patients with tuberculosis (TB) attending 2 chest facilities in Alexandria, Egypt for the year 2003. A pre-coded checklist was used for auditing medical records. Conformity to the DOTS drug regimen during the continuation phase of therapy, conformity to the recommended schedule of sputum smear microscopy, and quality of registration of medical records were the 3 variables that significantly predicted treatment success. About half the patients received poor quality care. Strict adherence to standardized DOTS strategy is essential to bring TB under control. The overall quality index devised in this study may be used to assess and improve overall quality of antituberculosis care.