Tuberculosis (TB) TB disease is still a health threat both worldwide and in Indonesia. Cases of TB disease in Majalengka District continued to increase in 2020, with as many as 9,497 cases; in 2021, as many as 12,692 cases; and in 2022, a significant increase of 21,956 cases. This study aims to determine patient characteristics, level of adherence, and effectiveness of TB treatment, as well as the relationship between adherence and effectiveness of TB treatment in a hospital in Majalengka District in West Java. The research method used was descriptive observational analysis with retrospective data collection based on TB patient treatment cards. Adherence data was collected by completing the MMAS-8 questionnaire, and effectiveness data were collected by recording sputum examination results using SITB software. The sample is the total population according to the criteria. The technique used to draw this sample was total sampling, namely the total number of TB patients in a Hospital from November 2023 to April 2024, which was 45 patients. Data analysis was done using the Chi-square test. A total of 95.6% had a high level of adherence, and 4.4% of patients had moderate adherence. The efficacy of TB treatment was 100%, with 97.8% cured status and 2.2% complete treatment. There was a significant relationship between adherence and TB treatment effectiveness, with a p-value of 0.044 (sig<0.05).