Tuberculosis program effectiveness is majorly measured by disease severity and treatment response without integrating patient perspectives, yet, it’s a critical dimension in clinical decision- making that enhances health worker-patient interactions and increases individuals' sustained engagement with treatment thereby benefiting not only the people affected by tuberculosis but also the wider public by mitigating the infection risk. This study assessed tuberculosis patients' lived experiences, level of self-efficacy, and quality of life in Nairobi County, Kenya. A cross-sectional study design with mixed-method research, triangulation design, and convergence model was used, employing a partially mixed, concurrent, dominant design. Interviews were conducted between May and June 2023 in five sub-counties namely: Ruaraka, Dagorretti, Langata, Starehe, and Embakasi East among drug-sensitive tuberculosis patients in the continuation phase of treatment. Additionally, a phenomenology approach was used to explore the lived experiences of the patients in focused group discussions and key informant interviews, which were audio recorded and transcribed verbatim followed by coding and thematic analysis. A two-stage cluster sampling was done based on the 2021 county tuberculosis workload. First, five sub-counties with the highest cases were purposively selected. Secondly, facilities with the highest cases were also purposively selected. Participants were then selected through simple random sampling(n=392) from a population of 2961. R statistical software and Microsoft excel were used for descriptive and inferential statistics where Spearman’s correlation was used to assess the association of the different domains to the overall self efficacy and quality of life levels, while analysis of variance was used to measure the mean differences across the domains of self efficacy and quality of life. Different themes were identified including low knowledge level on prevention and control strategies, perceived wellness, facility preference, missed appointments among the special population, food insecurity stigma, side effects, pill burden and economic effects of tuberculosis. The overall self efficacy level was low 349 (89.03%) with a moderate positive correlation between the different domains (knowledge, collective, psycho-emotional, functionality) and the overall level. All the domains were statistically significant (p=<0.05). The overall quality of life level was also low, 97(50.26%) with the domains (physical, socioeconomic, psychosocial) having a strong positive correlation with the overall level except the spiritual domain which had a weak positive correlation. All the domains were statistically significant(p=<0.05) except the spiritual domain. These findings suggest that patients’ experiences may affect treatment outcomes and that improving their levels of self efficacy, and quality of life may help improve treatment outcomes. Therefore, in addition to the clinical outcomes, the tuberculosis program should consider adding patients’ perceptions in the monitoring and evaluation tools, include the socio-economic and psychological dimensions that impact the disease and its treatment in the treatment package, including nutritional support for street families and vulnerable groups. They should also consider using self efficacy and quality of life more frequently and perhaps include them in forthcoming guidelines.