OBJECTIVES: The study was conducted to find the role of TB home observer (TB.H.O) in improving the clinical outcome of TB patients in two major prevalence TB cities in Yemen METHODS: The prospective multicenter study was conducted among Tuberculosis (TB) patients. The study was undertaken in two high burden TB cities (Alhodiah and Taiz) in Yemen. Around 628 TB patients were registered between March 2014 to August 2014. Only 413 TB patients were interviewed giving a responses rate of 67%. Patients were follow-up until the final treatment outcome was recorded. About 240 TB home observers (TB.H.O) meet the criteria were agreed to participate in the study. Furthermore, short classes were given to TB.H.O at the beginning of treatment course about important of treatments and their role in improving the the clinical treatment outcome. RESULTS: The result shows that treatment outcome of TB patients having observers is significant compared to those not having.  CONCLUSIONS: Our finding is expected to be useful for directly observed treatment (DOTS) workers and National Tuberculosis Control Program (NTCP) to assign a supportive during Patient treatment which may enhance the success rate of TB Patients.