Equipping medical graduates with the competence to manage tuberculosis is not just imperative, but also urgent as the disease has been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS), which forms the basis of this study. A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms, and management of tuberculosis under DOTS. The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guidelines into existing undergraduate medical education curriculum, as well as student rotations through activities in DOTS clinics.