With 2 Million TB cases being added every year, India leads the world having one fifth of new cases every year. To control the TB, two important programmes have been launched in India i.e. IDSP and RNTCP. Even after 14 years of implementation of RNTCP, the early control is not in sight. This evaluation of programmes at the grassroot level clearly show that we are missing the target at the village level because of lack of manpower, equipment and reach to the target population. There is no coordination between the IDSP and the RNTCP. Stigma due to TB is widely prevalent and DOTS providers are finding it difficult to follow all cases. The failure of the management at district level to implement both these programmes in India is contributing to the inability of the programmes to capture and treat all the cases in the community and is contributing to high default rate and emergence of resistant strains. This study looks at the micro level gaps that are there in the system at the grassroot level and recommends to fill these gaps for better implementation to achieve the objective of effective TB control in India.