Abstract: Tuberculosis is a major cause of preventable disease and death in women. This study was done in Zabol, in the Southeast of Iran which is a highly endemic region of Iran to determine the gender differences in tuberculosis. Two thousand two hundred and eighty four cases of tuberculous patients were identified during 2000-2004 in this region. There were 1375 females and 909 males, with a female: Male ratio of 1.5. The notification cases of sputum positive pulmonary tuberculosis during this period were 726 females and 479 males. Women of reproductive age were the most affected groups. Although the numbers of failure to treatment, relapsed and died patients were higher in women but they were not statistically significant. Tuberculosis still remains a public health issue in this part of Iran, especially in women. Therefore tuberculosis control programs should be gender sensitive.