OBJECTIVES To assess the direct and indirect medical costs incurred in the treatment of tuberculosis (TB) in patients attending public hospitals in Pakistan.  METHODS A descriptive cross-sectional study was conducted in patients attending Accident and Emergency and TB wards of the hospitals in Pakistan by convenient-sampling technique. The direct and indirect medical costs were determined by various parameters like consultation fees, cost of medicines, travelling costs and laboratory test expenses etc.  All obtained data were analyzed using descriptive and inferential statistics. RESULTS The mean annual direct medical cost for a TB patient was around Rs. 17317.56 (US$ 176.26) and indirect medical cost was Rs. 12918.50 (US$ 131.48). It was also observed that ccomparatively higher direct and indirect medical costs per patient (p < 0.001) were associated with large and urban hospitals. Besides, association of indirect medical costs with gender and age were the persuasive predictors of the study. CONCLUSIONS Severity of the disease, distance to the hospital and length of stay in the hospital were proportional to the direct and indirect medical costs. In Pakistan, a significant proportion of the direct medical cost for TB treatment is subsidized for the public.