Pulmonary Tuberculosis (TB) is a global public health threat. It has a worldwide distribution with a very high prevalence in Asian countries. A correct diagnosis forms an important and indispensable part of proper and timely treatment. Detection of acid fast bacilli in direct smears has considerable clinical and epidemiological value and remains the most widely used rapid diagnostic test. In smear negative cases, radiography has an important role to play. Directly Observed Treatment Short Course (DOTS) strategy is one of the most cost-effective health interventions to treat tuberculosis. Samples from clinically suspected cases of TB were screened for the presence of Acid Fast Bacilli (AFB). Radiography and culture was done for the AFB negative cases. 760 cases of pulmonary TB were diagnosed by smear examination and 412 by radiography. 270 cases of pulmonary TB were diagnosed in the study. Of the 1422 patients put on DOTS, out of which 1138 (80.1%) were successfully treated. Thus, smear examination for AFB and radiography should go hand in hand for correct diagnosis and treatment of TB by DOTS which is a very successful regimen for developing countries like India.