Introduction: Tuberculosis is one of the leading causes of death among infectious diseases in developing and undeveloped countries. According to the WHO Western Pacific Region fact sheet on tuberculosis. Hepatotoxicity, a common adverse effect of anti-tuberculosis drugs, varies from asymptomatic elevation of liver enzymes to fulminant hepatic failure. Methods: The study protocol was approved by the Ethics Committee on Human Rights related research. Results. From the total of 55 patients, there were no significant differences in the distribution of the demographic characteristics. Antituberculosis drug-induced hepatotoxicity (ATDH) was seen in 17 (18.8%) out of 90 patients. Average age of the ATDH case was 35.65 ± 10.8 (CL 95% 18-81) sex ratio was 22.5% in men, 16% in women. During pre and post-treatment liver biochemical analyzes criteria such as AST, ALT, total bilirubin, and protein were not statistical significant between groups which are treated with Silymarin. However, in control group had a statistically significant difference total bilirubin and protein between pre and post-treatment liver biochemical analyzes criteria such as AST, ALT. Anti-tuberculosis drugs are used in combination, except in latent tuberculosis or chemoprophylaxis. The rate of hepatotoxicity is much higher in developing countries like India (8%–30%) compared to that in advanced countries. Therefore, we selected patients who have tuberculosis to study the hepatotoxic effect of antituberculosis drugs and hepatoprotective action of Silymarin. The serum ALT, AST of the control group (group I) and the Silymarin group (group II, III) show significant difference when compared with baseline values. This showed that Silymarin has significant desired actions. Conclusions Silymarin reduced the incidence of antiTB-DILI. The benefit of Silymarin may be explained from superoxide dismutase restoration. Larger clinical trials are required to confirm the result of our small study. References 1. WHO.Global tuberculos report 2014