Introduction: Prevalence of childhood TB has been reported to be between 3% and 25 % in different countries. It remains under reported in developing countries like India due to diagnostic difficulties, poor reporting and recording system. Objectives: (1) To compare the differences between adult and pediatric TB in terms of disease type, category and outcome of treatment. (2) To determine whether childhood TB was an important predictor of adverse outcome following treatment under the Revised National TB Control Programme (RNTCP). Methods: Study design: Retrospective record based study. Study Area: This record based study was done at District Tuberculosis center in Kollam. Sample Size: All the TB cases from 2012 January to December 2012 of all age groups, which were registered in the district TB Centre, were selected. There were total 605 patients registered. Results: Out of total 605 tuberculosis patients, 549(90.7%) were adults and 56(9.3 %) were pediatric. In adult age group 394 (71.8 %) were males and 155 (28.2%) females. Among the pediatric age group, 35(62.5%) were males and 21(37.5%) were females. Pediatric age group had 53 (94.65%) cases under pulmonary disease type and 3 (5.4%) were extra pulmonary. Similarly in adults 476 (86.7%) were pulmonary and 77 (14.1%) extra pulmonary tuberculosis. This difference was statistically significant (P 0.043). All pediatric age groups were treated under category 1, while among the adults 476 (86.7%) were treated under category 1. Conclusion: There were differences in the clinical presentation of TB among children and adults. In case of treatment outcomes, pediatrics age group had better outcome than adults.