Aim: There is consistent evidence that tobacco smoking has been implicated as a risk factor for tuberculosis infection, disease and death. Study was aimed to identify the impact of smoking on Tuberculosis (TB) clinical characteristics and treatment outcome and to emphasize this association thus may be useful in the management of TB cases. Method: The retrospective, observational and cross-sectional cohort survey was done to compare disease characteristic and clinical presentation during treatment of TB. Result: Five hundred twenty four TB patients were consecutively recruited during the period of the study. Of this, 250 [47.7%] were never smokers. Ever smoking TB patients accounted for 274 [52.3%]. There were significant relationships between smoking status of TB patient with race and initial Mantoux test. But there were no significant association between smoking habit and marital status, patients’ identities, history of chronic disease, history of contact to pulmonary TB patients and BCG scar. Ever smoker TB patients’ were four times more likely to have slower smear conversion at two months compared to non-smoker tuberculosis patients’. Conclusion: We found a high risk of death from smoking induce tuberculosis. Treatment outcomes were not statistically significant with/without smoking. It was seen that smoking is consider as a risk factor for unfavorable outcomes among TB patients registered in DOTS program in term of therapeutic compliance.