OBJECTIVES: To assess the cost-effectiveness of mobile phone “contact-reminder” compared to self-administered treatment (SAT) to control tuberculosis (TB) in Thailand. METHODS: Cost-effectiveness analysis was undertaken using a decision tree model, which included three stages of treatment; initial treatment, re-treatment, and multi-drug resistant TB treatment. Costs (2005 international dollars: I$) were calculated based on treatment periods and treatment outcomes. Health outcomes were estimated over the lifetime of smear-positive pulmonary TB patients in disability-adjusted life years (DALYs). Both costs and health outcomes were discounted 3% annually. Mobile phone reminders are a relatively new TB treatment strategy. A pilot study reported a mortality rate far higher than observed using other strategies, but there were reasons to suspect this was influenced by the high age and co-morbidities of the trial sample. We undertook a sensitivity analysis using mortality rates observed during other treatment strategies, to indicate if mobile phone reminders could be cost-effective in Thailand. RESULTS: Sensitivity analysis showed lowering the mortality rate to values observed in trials of other treatment strategies made the mobile phone reminder intervention more cost-effective than SAT, as a result of an increase in the DALYs averted. Using the highest (8%) and the lowest (3%) death rates from the other TB control strategies, the probability that the mobile phone intervention was more cost-effective than SAT was 98% and 100%, respectively. CONCLUSIONS: If further trials show the mortality rate using a mobile phone reminder system to be similar to that observed under other treatment strategies, this strategy would be more cost-effective than SAT. A bigger study with control group and proper age distribution is needed to examine the true merits of mobile phone intervention.