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Background: Ensuring that the patient comprehends and correctly implements the physician's/health care worker's instructions is crucial in the treatment of Tuberculosis (TB). Our study aimed to assess the Heath Literacy (HL) of patients with TB using the Newest Vital Sign (NVS) HL tool translated to Kannada language. Aim and Objectives: To develop a translated version of the NVS HL tool in the Kannada language and assess the HL of patients with TB. Material and Methods: Two professional translators translated the NVS-United Kingdom version to Kannada language independently. The content of the translated version was assessed by a team of six medical and non-medical personnel, followed by back-translation of the modified version. The translated NVS tool, which was modified to culturally adapt the contents to the Indian scenario, was pilot tested among 15 individuals from the general population to determine the internal validity of the questionnaire, which indicated good reliability (Cronbach's alpha 0.806). Further, a cross-sectional study was conducted at a TB center in Karnataka, India. The translated NVS was administered to 50 patients with drug-sensitive and drug-resistant TB each. The correlation between the HL scores and educational and socioeconomic status was determined. Results: The median HL score of the study participants was 1, and the median time to answer the questionnaire was 10 minutes. The percentage of patients with limited, intermediate, and adequate HL scores were 54%, 32%, and 14%, respectively. A moderate positive correlation was seen between the educational level and the NVS scores (r = 0.480, P < 0.001). Conclusion: A large number of patients with TB have limited HL. The HL status of an individual correlates with the level of education but not with gender or socioeconomic status. NVS-Kannada is a reliable tool to measure HL in the Kannada-speaking population.