Abstract : Tuberculosis remains a persistent and ancient challenge for humanity. The meticulous efforts dedicated for tuberculosis elimination encountered a setback with the unprecedented arrival of the COVID-19 pandemic as resources were stretched and TB services disrupted. To assess the impact of COVID-19 pandemic on NTEP services – Diagnosis, treatment, follow-up and support services and to assess the challenges faced by individuals in availing the NTEP services during the COVID-19 pandemic. An Explanatory Sequential Design mixed-method approach was adopted. A five-year retrospective analysis of district-level programmatic indicators was conducted, covering the period from 1st January 2017 to 31st December 2021. A survey and sub-analysis were performed on five time-based cohorts of persons with TB registered between September 25, 2019 and June 30, 2021. This aimed to identify challenges faced by individuals during the pandemic. A 17% decline in TB case notification in 2020 compared to 2019 was noted indicating the pandemic's influence. The treatment success rate was 78.6% before the pandemic, increasing to 83.8% during pandemic showing no negative influence of the pandemic. No changes were noted in the death rates. Challenges in accessing NTEP services included difficulty in obtaining medications, irregular medicine supply, drugs for treatment initiation, lack of transportation for centre visits, unavailability of doctors, and centre closure. Despite the challenges posed by the pandemic, NTEP services have demonstrated remarkable resilience, finding innovative ways to continue their critical work of TB control while navigating the uncertainties and disruptions caused by COVID-19.