Factors that influence the effectiveness of Community Based Tuberculosis Care (CBTC) may differ depending on population setting, characteristics, cultural practices, life style and economic status. It is unclear factors that influence the effectiveness of CBTC with reported low case notification rate (280 per cases 100, 000 populations), low treatment success rate (<90%) below the WHO target of 90% and above followed by low community referrals (<9%) (MOH, 2014). This was a descriptive cross- sectional study design that collected quantitative and qualitative data to determine the effectiveness of Community based tuberculosis care (CTBC) among patients in Meru County. The main objective of the study was to determine factors that influence the effectiveness of CBTC among TB patients aged 18 years and above in Meru County. Specific objective included determinations of demographic factors, socio-economic factors, treatment factors, to assess the role of community health volunteers and to assess the patient's perceptions in Meru County. The study was conducted in Meru County health facilities implementing CBTC. Semi-structured questionnaires and key informants guide were used to collect data from the respondents. A sample size of 345 respondents were enrolled from high and low volume tuberculosis control zones and at the facility level (2:1). Simple random sampling, was used to select the health facilities, proportionate sampling was used to identify the number of participants to be enrolled in each facility, At the facility level simple random sampling method was used to identify participants during drug refill days. Quantitative data were analyzed using SPSS version 24 for statistics and STATA version 13 was used for inferential statistics. Qualitative data was transcribed manually. Overall 345 patients were recruited to participate in the study. The mean age of the respondents was 37.17 (+2) years and a standard deviation of 12.528 years. Majority of the respondents were males 267(77.4%), females only 78(22.6%). The respondents who had attained primary level of education 247(71.55%). Majority of the respondents were aged 18-36 years 195(56.5%). The main source of income the study respondents was mainly employment 217(62%). Majority of the respondents 210 (60.9%) took less than three months before seeking treatment despite having experienced signs and symptoms of tuberculosis. Effectiveness of CBTC improved with the age and level of education of the respondents at OR 1.39, 1.79 and OR 1.01, 1.02 respectively, although there was no significant association (p-0.076, p-0.788 respectively). The effectiveness of community based tuberculosis increased with the frequency of tuberculosis related outreach services; having outreach services on monthly basis was more effective at OR-1.00 compared to quarterly and annually at OR -0.29, OR-0.21 respectively at a confidence interval of 95% (CI 0.04-1.90). The study concluded that: Majority of the study respondents were males of primary level of education residing in rural areas. Majority of the respondents had temporary employment which had low income of below Kshs.10, 000 per month. Majority of treatment supporters were trained by healthcare workers before initiation of tuberculosis treatment. Minimal numbers of households were visited by community health volunteers within the first month of treatment. The study recommended that: Enhanced programs on tuberculosis should be designed and focused to male gender in the periphery. Enhance community based social protection measures such as cash transfer or incentives. Upscaling dissemination of knowledge on tuberculosis by health professionals. Training of more community health volunteers on basis modules of tuberculosis to improve household visits within one month of initiation of treatment.