Background: Tuberculosis is most common infectious disease in developing countries. New rapid molecular diagnostics could dramatically increase TB detection and linkageto-care, which are key components of both the World Health Organization’s (WHO) End TB Strategy and India’s National Strategic Plan for Tuberculosis Elimination 2017–2025. Aim: To compare the Truenat with sputum smear microscopy. Material and Methods: The study was conducted in a tertiary care hospital, Gujarat. 150 patients having symptoms related to tuberculosis were tested for sputum smear microscopy as well as by Truenat for molecular diagnosis of tuberculosis and rifampicin resistance at Microbiology laboratory. Results: Out of 150 samples 54 samples shows positive results for Mycobacterium tuberculosis by smear microscopy and 69 samples shows positive results by truenat for detection of Mycobacterium tuberculosis. Amongst 69 samples 7 samples shows rifampicin resistance while rest 62 shows rifampicin sensitive. Conclusion: As truenat MTB is portable, TrueNAT could increase treatment initiation by reducing turnaround time for test results and decreasing the need for laboratory referrals at developing countries.