In 1993, the WHO declared that tuberculosis is a global emergency. Tuberculosis can be controlled effectively with existing tools. WHO introduced the Directly Observed Treatment [DOTS] to address these problems. In Egypt, the National TB control Program [NTP] applied DOTS in 1996. The aims of this study were to portray the epidemiological features of the disease and to assess the impact of DOTS strategy on morbidity and mortality of TB. The descriptive approach was selected where the inference population was records of all TB dispensaries [seven] serving the governorate. Data obtained included: age, gender and types of TB cases registered in these clinics for the year 2000. In addition, the total number of notified cases in 1990 and 1995 was also obtained. Data was then prepared to obtain incidence, prevalence, as well as treatment outcome indicators. The results of the study revealed that a total of 639 cases were reported in year 2000 giving a prevalence rate of 18.00 per 100,000 population. Of the total number of TB cases, 58.1% were pulmonary smear-positive giving an incidence of 8.76 per 100,000 population with a case detection rate of 54.8%. The prevalence rate of TB was 48.92 per 100,000 in the year 1990. It dropped to 35.24 per 100,000 in year 1995 indicating a reduction of 4.08% per year. The prevalence in year 2000 was 18.00 per 100,000 showing a further reduction of 9.78% per year. Among the total cases, the smear conversion rate was 90.4% and the success rate was 77.5%. On the other hand, the case fatality rate was 4.5%, the failure rate was 3.2%, the defaulter rate was 4.8%, and the transfer out rate was 6.1%. A substantial reduction in the magnitude of TB problem in Alexandria was achieved after the application of DOTS strategy. However, until now the targets specified nationally and globally were not achieved.