OBJECTIVES: In the mountain kingdom of Nepal, nearly 44,000 new cases of the tuberculosis (TB) appear every year. This study explores community valuation of TB prevention by estimating household and community willingness to pay (WTP) for the prevention of transmission and treatment of TB in the rural areas of mid-Nepal. METHODS: A contingent valuation survey was used to assess individual WTP for specific prevention and treatment interventions for TB. In order to estimate confidence limits in mean WTP and to generate a distribution of WTP for the community, accounting for uncertainty in regression coefficients and variability within the population, a two-dimensional Monte Carlo simulation was also developed. RESULTS: The study results show a mean WTP of $0.81 per month per household (90% CL: $0.43, $1.61) to prevent transmission of TB. However, the mean WTP for TB treatment was estimated to be $2.31 per month (90% CL: $1.32, $3.47) per household. Nearly 22% and 47% of household were not willing to pay for prevention and treatment of TB, respectively. As expected, income positively affected estimates of mean WTP for both TB treatment and prevention. An individual’s familiarity with TB and superstitions significantly negatively influenced WTP for treatment and prevention. Contrary to expectation, WTP for TB treatment and prevention was not influenced by religion and ethnicity in the rural villages of Nepal. In our study, sex and health education do not show any significant affects on WTP for transmission prevention and treatment interventions of TB. CONCLUSIONS: These results show that the majority of the community places a positive value on both prevention and treatment of TB. Mean WTP provides monetary estimate of over all benefit of TB prevention and treatment program. The study results suggest socio-economic factors and knowledge about TB as major determinants of WTP.