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Abstract Objective: The objective was to bring evidence about the contribution of seasonal migration to defaulting and low treatment success rate (TSR) in Balochistan province of Pakistan. Methods: Directly Observed Therapy (DOTS) has been implemented in 22 districts of Balochistan province. A cohort study was conducted in five randomly selected districts between October 2005 and March 2006. A total of 291 new PTB patients during the two quarters were interviewed before summer migration by using a structured and pre-tested interview schedule regarding their health seeking behavior and other determinants about seasonal migration to determine default and TSR among migrant and non-migrant patients. Results: The overall default rate at surveyed districts was very low (2.4%) as compared to national level which is 17%, whereas it was 4.4% among migrant patients. It was evident that TSR was also high which was 96% and 100% among migrant and non-migrant patients respectively. It shows that migration has very low impact on default and low TSR. The main factors of low default and high TSR were the high commitment of patients for seeking their medical checkup as well as regularity in medication by both migrant as well as non-migrant patients. Conclusion: The high degree of commitment for seeking medical checkup and regularity in medication were the two main factors for low default rate and high TSR in the surveyed districts. Introduction Tuberculoses is endemic in Pakistan. With the population of 152 million about 1.5 million people are infected and Pakistan ranks sixth among the 22 high-burden tuberculosis countries worldwide (177 per 100,000) and death toll due to TB mounts to round 50,000 annually. 1 About 75% patients fall in the earning age group 14-49 years